Table III.
The number of open long bone fractures of lower limb by compliance with the Open Fracture British Orthopaedic Association Standards for Trauma clinical standards and chronological time of presentation at hospital within the Trauma Audit Research Network dataset between 2008 and 2019 in England.
| Variable | Total patients, n (%) | 2008 to 2011, n (%) | 2012 to 2015, n (%) | 2016 to 2019, n (%) |
|---|---|---|---|---|
| Total who were BOAST-eligible | 12,170 (100) | 3,912 (100) | 4,267 (100) | 3,991 (100) |
| Combined orthopaedic and plastic surgery management plan | ||||
| Yes | 4,577 (38) | 341 (9) | 2,193 (51) | 2,043 (51) |
| No | 1,635 (13) | 392 (10) | 970 (23) | 273 (7) |
| Missing | 5,958 (49) | 3,179 (81) | 1,104 (26) | 1,675 (42) |
| ‘Yes’ of those recorded* | 4,577 (74) | 341 (47) | 2,193 (69) | 2,043 (88) |
| Systematic assessment of vascular and neurological status | ||||
| Yes | 4,800 (39) | 487 (21) | 2,464 (58) | 1,849 (46) |
| No | 1,074 (9) | 162 (4) | 556 (13) | 356 (9) |
| Missing | 6,296 (52) | 3,263 (83) | 1,247 (29) | 1,786 (45) |
| ‘Yes’ of those recorded* | 4,800 (82) | 487 (75) | 2,464 (82) | 1,849 (84) |
| Antibiotics given within one hour of incident? | ||||
| Yes | 6,795 (56) | 1,673 (43) | 3,001 (70) | 2,121 (53) |
| No | 572 (5) | 129 (3) | 198 (5) | 245 (6) |
| Missing | 4,803 (39) | 2,110 (54) | 1,068 (25) | 1,625 (41) |
| ‘Yes’ of those recorded* | 6,795 (92) | 1,673 (93) | 3,001 (94) | 2,121 (90) |
| Wound dressing – local guidance followed? | ||||
| Yes | 5,282 (43) | 1,156 (30) | 2,471 (58) | 1,655 (41) |
| No | 855 (7) | 112 (3) | 294 (7) | 449 (11) |
| Missing | 6,033 (50) | 2,644 (68) | 1,502 (35) | 1,887 (47) |
| ‘Yes’ of those recorded* | 5,282 (86) | 1,156 (91) | 2,471 (89) | 1,655 (79) |
| Limb splint – local standard met? | ||||
| Yes | 4,677 (38) | 1,586 (41) | 1,877 (44) | 1,214 (30) |
| No | 1,851 (15) | 180 (5) | 813 (19) | 858 (21) |
| Missing | 5,642 (46) | 2,146 (55) | 1,577 (37) | 1,919 (48) |
| ‘Yes’ of those recorded* | 4,677 (72) | 1,586 (90) | 1,877 (70) | 1,214 (59) |
| Did the fracture have surgical stabilization? | ||||
| Yes | 3,914 (32) | 10 (< 1) | 1,851 (43) | 2,053 (51) |
| No | 851 (7) | 3 (< 1) | 423 (10) | 425 (11) |
| Missing | 7,405 (61) | 3,899 (99) | 1,993 (47) | 1,513 (38) |
| ‘Yes’ of those recorded* | 3,914 (82) | 10 (77) | 1,851 (81) | 2,053 (83) |
| Was definitive soft-tissue cover of the injury achieved? | ||||
| Yes | 3,019 (25) | 3 (< 1) | 1,290 (30) | 1,726 (43) |
| No | 1,743 (14) | 10 (< 1) | 983 (23) | 750 (19) |
| Missing | 7,048 (61) | 3,899 (99) | 1,994 (47) | 1,515 (38) |
| ‘Yes’ of those recorded* | 3,019 (63) | 3 (23) | 1,290 (57) | 1,726 (70) |
| Was definitive coverage achieved within 72 hours? | ||||
| Yes | 1,622 (13) | 0 (0) | 550 (13) | 1,072 (27) |
| No | 654 (5) | 0 (0) | 171 (4) | 483 (12) |
| Missing | 9,894 (81) | 3,912 (100) | 3,546 (83) | 2,436 (61) |
| ‘Yes’ of those recorded* | 1,622 (71) | 0 (0) | 550 (76) | 1,072 (69) |
| Was definitive stabilization achieved at same time as wound coverage? | ||||
| Yes | 1,669 (14) | 0 (0) | 489 (11) | 1,180 (30) |
| No | 466 (4) | 0 (0) | 163 (4) | 303 (8) |
| Missing | 10,035 (82) | 3,912 (100) | 3,615 (85) | 2,508 (63) |
| ‘Yes’ of those recorded* | 1,669 (78) | 0 (0) | 489 (75) | 1,180 (80) |
| Gustilo-Anderson grade recorded? | ||||
| Yes | 4,253 (35) | 2 (< 1) | 1,590 (37) | 2,661 (67) |
| No | 1,142 (9) | 0 (0) | 107 (3) | 1,035 (26) |
| Missing | 4,498 (37) | 3,910 (99) | 293 (7) | 295 (7) |
| ‘Yes’ of those recorded* | 4,253 (79) | 2 (100) | 1,590 (94) | 2,661 (72) |
*
These numbers and percentages exclude the patients with missing data. Only those patients recorded as having a ‘Yes’ or a ‘No’ are included in the denominator for the percentage.
BOAST, British Orthopaedic Association Standards for Trauma.