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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
medicine
Risk factors for infection after 46,113 intramedullary nail operations in low- and middle-income countries
World Journal of Surgery, Volume 37, No. 2, Year 2013
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Description
Background: The fields of surgery and trauma care have largely been neglected in the global health discussion. As a result the idea that surgery is not safe or cost effective in resource-limited settings has gone unchallenged. The SIGN Online Surgical Database (SOSD) is now one of the largest databases on trauma surgery in low- and middle-income countries (LMIC). We wished to examine infection rates and risk factors for infection after IM nail operations in LMIC using this data. Methods: The SOSD contained 46,722 IM nail surgeries in 58 different LMIC; 46,113 IM nail operations were included for analysis. Results: The overall follow-up rate was 23.1 %. The overall infection rate was 1.0 %, 0.7 % for humerus, 0.8 % for femur, and 1.5 % for tibia fractures. If only nails with registered follow-up (n = 10,684) were included in analyses, infection rates were 2.9 % for humerus, 3.2 % for femur, and 6.9 % for tibia fractures. Prophylactic antibiotics reduced the risk of infection by 29 %. Operations for non-union had a doubled risk of infection. Risk of infection was reduced with increasing income level of the country. Conclusions: The overall infection rates were low, and well within acceptable levels, suggesting that it is safe to do IM nailing in low-income countries. The fact that operations for non-union have twice the risk of infection compared to primary fracture surgery further supports the use of IM nailing as the primary treatment for femur fractures in LMIC. © 2012 The Author(s).
Authors & Co-Authors
Young, Sven
Norway, Bergen
Haukeland Universitetssjukehus
Norway, Bergen
Universitetet I Bergen
Malawi, Lilongwe
Kamuzu Central Hospital
Lie, S. A.
Norway, Bergen
Universitetet I Bergen
Norway, Bergen
The Norwegian Arthroplasty Register
Hallan, Geir
Norway, Bergen
Haukeland Universitetssjukehus
Norway, Bergen
The Norwegian Arthroplasty Register
Zirkle, Lewis G.
United States, Richland
Sign Fracture Care International
Engesæter, Lars Birger
Norway, Bergen
Haukeland Universitetssjukehus
Norway, Bergen
Universitetet I Bergen
Norway, Bergen
The Norwegian Arthroplasty Register
Havelin, Leif Ivar
Norway, Bergen
Haukeland Universitetssjukehus
Norway, Bergen
Universitetet I Bergen
Norway, Bergen
The Norwegian Arthroplasty Register
Statistics
Citations: 89
Authors: 6
Affiliations: 5
Identifiers
Doi:
10.1007/s00268-012-1817-4
ISSN:
03642313
e-ISSN:
14322323
Research Areas
Health System And Policy
Violence And Injury
Study Design
Cohort Study