Abstract
Open femoral fractures are common; however, many factors may affect treatment protocol. We aim to assess any racial/ethnic or sex disparities associated with the definitive fixation of open femoral fractures. ICD-9 codes from the National Trauma Data Bank (2007 to 2010) for patients greater than or equal to 18 years with open femoral fractures who underwent operative management at level I or II trauma centers were identified and analyzed. Of the 9,406 cases, the majority were White (61%), men (73%), and aged between 25 and 44 years (41%). The odds of definitive fixation after hospital day 2 (odds ratio [OR] .96, 95% confidence interval [CI] .82 to 1.09, P = .53) or any complication (OR .96, 95% CI .79 to 1.15, P = .69) were not associated with race/ethnicity. Men were 17% less likely to have surgery after hospital day 2 (OR .83, 95% CI .78 to .96, P < .001), and 18% more likely to have a complication (OR 1.18, 95% CI 1.03 to 1.35, P = .02). There are no racial/ethnic disparities associated with the timing of definitive fixation. Men are more likely to undergo fixation earlier than women; however, they are more likely to have a complication. Fixation within the first 2 hospital days may decrease complications.
References
Jan 1, 1991·Journal of Orthopaedic Trauma·A Green, P G Trafton
Aug 13, 2002·Journal of Orthopaedic Trauma·Brian J HarleyDonald W Weber
Aug 25, 2007·Annals of Surgery·Edwin A DeitchGeorge W Machiedo
Jan 26, 2008·Medical Care·Melanie ArthurRichard J Mullins
Oct 22, 2008·Archives of Surgery·Adil H HaiderEdward E Cornwell
Jan 27, 2010·Journal of Orthopaedic Trauma·Michael A FlierlPhilip F Stahel
Feb 2, 2010·Journal of the American College of Surgeons·Barton H HamiltonBruce Lee Hall
May 11, 2010·The Journal of Trauma·Ben L ZarzaurTimothy C Fabian
Jul 17, 2010·Surgery·Rubie Sue MayburyAdil H Haider
Sep 15, 2010·The Journal of Trauma·Adil H HaiderEdward E Cornwell
Feb 22, 2011·The Journal of Trauma·Nickolas J NahmHeather A Vallier
May 3, 2012·Journal of Orthopaedic Trauma·Philipp N StreubelWilliam T Obremskey
Nov 3, 2012·The Journal of Trauma and Acute Care Surgery·Nickolas J Nahm, Heather A Vallier
Apr 24, 2013·The Journal of Trauma and Acute Care Surgery·Adil H HaiderLisa A Cooper
Jun 26, 2013·Wiener klinische Wochenschrift·Florian M KovarPatrick Platzer
Apr 4, 2014·The Journal of Bone and Joint Surgery. American Volume·Jeremy S SomersonBoris A Zelle