Table I.
Descriptive characteristics of patients with open fractures and severe open fracture of the tibia treated in England from 2008 to 2019, as recorded by the Trauma Audit and Research Network.
| Characteristic | All open fractures, n (%) | Severe open fracture of the tibia, n (%) |
|---|---|---|
| Total number of patients | 38,347 (100) | 12,170 (100) |
| Sex | ||
| Male | 23,123 (60) | 7,731 (64) |
| Female | 15,224 (40) | 4,439 (36) |
| Age, yrs | ||
| 0 to 9 | 833 (2) | 319 (3) |
| 10 to 19 | 3,337 (9) | 1,163 (10) |
| 20 to 29 | 6,120 (16) | 1,931 (16) |
| 30 to 39 | 4,864 (13) | 1,614 (13) |
| 40 to 49 | 5,142 (13) | 1,719 (14) |
| 50 to 59 | 4,959 (13) | 1,658 (14) |
| 60 to 69 | 4,128 (11) | 1,309 (11) |
| 70 to 79 | 3,779 (10) | 1,072 (9) |
| 80 to 89 | 3,801 (10) | 965 (8) |
| 90+ | 1,384 (4) | 420 (3) |
| Year of arrival at hospital | ||
| 2008 | 1,294 (3) | 609 (5) |
| 2009 | 1,713 (4) | 845 (7) |
| 2010 | 2,149 (6) | 1,058 (9) |
| 2011 | 2,699 (7) | 1,400 (12) |
| 2012 | 3,252 (8) | 1,538 (13) |
| 2013 | 3,479 (9) | 1,031 (8) |
| 2014 | 3,679 (10) | 830 (7) |
| 2015 | 3,764 (10) | 868 (7) |
| 2016 | 3,828 (10) | 809 (7) |
| 2017 | 4,189 (11) | 1,032 (8) |
| 2018 | 4,343 (11) | 1,131 (9) |
| 2019 | 3,958 (10) | 1,019 (8) |
| Day and time of presentation at hospital | ||
| Monday 00:00-07:59 | 681 (2) | 219 (2) |
| Monday 08:00-15:59 | 2,004 (5) | 653 (5) |
| Monday 16:00-23:59 | 2,289 (6) | 736 (6) |
| Tuesday 00:00-07:59 | 669 (2) | 218 (2) |
| Tuesday 08:00-15:59 | 2,173 (6) | 678 (6) |
| Tuesday 16:00-23:59 | 2,330 (6) | 761 (6) |
| Wednesday 00:00-07:59 | 605 (2) | 170 (1) |
| Wednesday 08:00-15:59 | 2,035 (5) | 647 (5) |
| Wednesday 16:00-23:59 | 2,328 (6) | 744 (6) |
| Thursday 00:00-07:59 | 695 (2) | 227 (2) |
| Thursday 08:00-15:59 | 2,239 (6) | 715 (6) |
| Thursday 16:00-23:59 | 2,499 (7) | 779 (6) |
| Friday 00:00-07:59 | 767 (2) | 235 (2) |
| Friday 08:00-15:59 | 2,231 (6) | 654 (5) |
| Friday 16:00-23:59 | 2,633 (7) | 851 (7) |
| Saturday 00:00-07:59 | 1,283 (3) | 414 (3) |
| Saturday 08:00-15:59 | 2,173 (6) | 641 (5) |
| Saturday 16:00-23:59 | 2,571 (7) | 853 (7) |
| Sunday 00:00-07:59 | 1,307 (3) | 441 (4) |
| Sunday 08:00-15:59 | 2,099 (5) | 623 (5) |
| Sunday 16:00-23:59 | 2,348 (6) | 738 (6) |
| Missing | 388 (1) | 173 (1) |
| Most severely injured body region | ||
| Abdo | 197 (1) | 33 (< 1) |
| Chest | 1,635 (4) | 326 (3) |
| Face | 2 (< 1) | 0 (0) |
| Head | 1,571 (4) | 424 (3) |
| Limbs | 30,753 (80) | 10,429 (86) |
| Multiple | 3,996 (10) | 914 (8) |
| Other | 19 (< 1) | 5 (< 1) |
| Spine | 174 (< 1) | 39 (< 1) |
| AIS Limb | ||
| 0 | 264 (1) | 0 (0) |
| 1 | 47 (< 1) | 0 (0) |
| 2 | 7,506 (20) | 0 (0) |
| 3 | 30,453 (79) | 12,156 (100) |
| 4 | 77 (< 1) | 14 (< 1) |
| ISS | ||
| All open fractures, mean (SD) | 12.7 (10.3) | |
| Open long bone fracture of lower limb, mean (SD) | 12.9 (9.4) | |
| ISS | ||
| 1 to 8 (minor) | 5,590 (15) | 0 (0) |
| 9 to 15 (moderate) | 25,024 (65) | 10,072 (83) |
| 16 to 24 (severe) | 3,019 (8) | 751 (6) |
| > 24 (very severe) | 4,714 (12) | 1,347 (11) |
| Injury type | ||
| Blunt | 36,460 (95) | 11,583 (95) |
| Penetrating | 1,887 (5) | 587 (5) |
| Injury mechanism | ||
| Blast | 91 (< 1) | 0 (0) |
| Blow(s) without weapon | 1,474 (4) | 0 (0) |
| Burn | 2 (< 1) | 0 (0) |
| Crush | 770 (2) | 0 (0) |
| Fall < 2 m | 13,842 (36) | 4,025 (33) |
| Fall > 2 m | 4,356 (11) | 1,168 (10) |
| Other | 656 (2) | 1,191 (10) |
| Shooting | 373 (1) | 0 (0) |
| Stabbing | 340 (1) | 0 (0) |
| Vehicle incident/collision | 16,443 (43) | 5,786 (48) |
| Pre-existing condition? | ||
| Yes | 18,600 (49) | 5,573 (46) |
| No | 19,747 (51) | 6,597 (54) |
| Pre-existing conditions * | ||
| Hypertension | 6,204 (16) | 1,840 (15) |
| Asthma | 2,920 (8) | 902 (7) |
| Depression | 2,333 (6) | 732 (6) |
| Diabetes mellitus (type 2) | 1,803 (5) | 578 (5) |
| Alcohol abuse | 1,654 (4) | 575 (5) |
| Other - heart disease | 1,461 (4) | 440 (4) |
| COPD | 1,386 (4) | 398 (3) |
| Thyroid disease | 1,127 (3) | 312 (3) |
| Hypercholesterolaemia | 1,118 (3) | 304 (3) |
| Osteoporosis | 918 (2) | 206 (2) |
| Five most frequent operations * | ||
| Skin debridement | 18,581 (48) | 6,560 (54) |
| Internal fixation: other and debridement | 10,012 (26) | 3,757 (31) |
| Internal fixation: nail and debridement | 5,050 (13) | 2,659 (22) |
| External fixation to bone | 4,262 (11) | 1,957 (16) |
| Internal fixation: plate and debridement | 3,645 (10) | 1,777 (15) |
| Was the open fracture heavily contaminated? | ||
| Yes | N/A | 247 (< 1) |
| No | N/A | 5,770 (47) |
| Missing | N/A | 6,153 (51) |
| Was there vascular impairment? | ||
| Yes | N/A | 688 (6) |
| No | N/A | 5,316 (44) |
| Missing | N/A | 6,166 (51) |
*
Categories are not mutually exclusive.
AIS, Abbreviated Injury Scale; COPD, chronic obstructive pulmonay disease; IQR, interquartile range; ISS, Injury Severity Score; N/A, not available; SD, standard deviation.