Considerations in reducing the infection rate in open tibial fractures.

During the period from 1979 to 1980, 109 patients with open tibial fractures were treated by a cephalosporin and an aminoglycoside, and by saline and topical antibiotic wound irrigation; partial closure was used for Types I and II open tibial wounds, and all Type III wounds were left open. Stabilization was accomplished by plaster alone, external pins in plaster, or an external fixator with full transfixion pins. The overall infection rate was 4.5% (5 of 109 wounds) in this study. This represents a significant reduction from the previous infection rate of 14% in 254 open tibial fractures treated by the authors in previous years by all methods.