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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
Low infection rates after 34,361 intramedullary nail operations in 55 low- and middle-income countries: Validation of the Surgical Implant Generation Network (SIGN) Online Surgical Database
Acta Orthopaedica, Volume 82, No. 6, Year 2011
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Description
Background: The Surgical Implant Generation Network (SIGN) supplies intramedullary (IM) nails for the treatment of long bone fractures free of charge to hospitals in low- and middle-income countries (LMICs). Most operations are reported to the SIGN Online Surgical Database (SOSD). Follow-up has been reported to be low, however. We wanted to examine the pattern of follow-up and to assess whether infection rates could be trusted. Patients and methods: The SOSD contained 36,454 IM nail surgeries in 55 LMICs. We excluded humerus and hip fractures, and fractures without a registered surgical approach. This left 34,361 IM nails for analysis. A generalized additive regression model (gam) was used to explore the association between follow-up rates and infection rates. Results: The overall follow-up rate in the SOSD was 18.1% (95% CI: 17.7-18.5) and national follow-up rates ranged from 0% to 74.2%. The overall infection rate was 0.7% (CI: 0.6-0.8) for femoral fractures and 1.2% (CI: 1.0-1.4) for tibial fractures. If only nails with a registered follow-up visit were included (n = 6,224), infection rates were 3.5% (CI: 3.0-4.1) for femoral fractures and 7.3% (CI: 6.2-8.4) for tibial fractures. We found an increase in infection rates with increasing follow-up rates up to a level of 5%. Follow-up above 5% did not result in increased infection rates. Interpretation: Reported infection rates after IM nailing in the SOSD appear to be reliable and could be used for further research. The low infection rates suggest that IM nailing is a safe procedure also in low- and middle-income countries. Copyright: © Nordic Orthopaedic Federation.
Authors & Co-Authors
Young, Sven
Norway, Bergen
Haukeland Universitetssjukehus
Norway, Bergen
Universitetet I Bergen
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
Surgical Implant Generation Network Sign
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: 67
Authors: 6
Affiliations: 4
Identifiers
Doi:
10.3109/17453674.2011.636680
ISSN:
17453682
Research Areas
Health System And Policy
Violence And Injury
Study Design
Cohort Study