Abstract
Objectives: Treatment of segmental long bone defects is one of the areas of substantial controversy in current orthopaedic trauma. The main purpose of this survey was to determine current practice and practice variation within the Orthopaedic Trauma Association (OTA) membership on this topic. Design: Survey. Setting: Web-based survey. Participants: Three hundred seventy-nine orthopaedic trauma surgeons. Methods: A 15-item questionnaire-based study titled "OTA Open Fracture Survey" was constructed. The survey was delivered to all OTA membership categories. Different components of the data charts were used to analyze various aspects of open fracture management, focusing on definitive treatment and materials used for grafting in "critical-sized" segmental bone defects. Results: Between July and August 2012, a total of 379/1545 members responded for a 25% response rate. Overall, 89.5% (339/379) of respondents use some sort of antibiotic cement spacer before bone grafting. It was found that 92% of respondents preferred to use some type of autograft at time of definitive grafting of segmental defects. When using a grafting technique, 88% said they used some type of antibiotic cement. Within that context, 60.1% said graft placement should be done at 6 weeks. Conclusions: There continues to be substantial variation in the timing of bone graft placement after soft tissue healing and the source and form of graft used. The use of antibiotic cement is common in segmental defects that require delayed bone grafting. Obtaining baseline practice characteristics on controversial topics will help provide a foundation for assessing research needs and, therefore, goals.
| Original language | English (US) |
|---|---|
| Pages (from-to) | e203-e207 |
| Journal | Journal of orthopaedic trauma |
| Volume | 28 |
| Issue number | 8 |
| DOIs | |
| State | Published - Aug 2014 |
Bibliographical note
Funding Information:The project described was supported by the National Center for Research Resources, Grant UL1 RR024975-01, and is now at the National Center for Advancing Translational Sciences, Grant 2 UL1 TR000445-06. The content is solely the responsibility of the authors and does not necessarily represent the official views of the NIH.
Funding Information:
Dr. W. T. Obremskey receives consulting fees from legal representatives and currently receiving a grant from the Southeastern Fracture Consortium; and his institution is receiving a grant from the Department of Defense. Dr. P. Tornetta III is salaried and supported by publication royalties from Smith & Nephew and Wolters Kluwer/Lippincott William & Wilkins; holds the intellectual property rights/patent & royalties from Smith & Nephew; receives consulting fees from Smith & Nephew. Dr. J. Ahn receives con-sulting fees from AO and Synthes; and his institution is currently receiving a grant from the Department of Defense. Dr. A. Schmidt is a current board member of the Orthopaedic Trauma Association; receives consulting and lecture fees from Medtronic, Inc; and his institution is currently receiving a grant from the Department of Defense. Dr. R. Probe certifies that he has or may receive payments or benefits from Stryker Orthopaedics, Mahwah, NJ, USA. Dr. R. Probe is on the Board of Trustees of Scott & White Healthcare and Chair, Board of Directors of Scott & White Memorial Hospital. The remaining authors report no conflict of interest.
Funding Information:
Dr. W. T. Obremskey receives consulting fees from legal representatives and currently receiving a grant from the Southeastern Fracture Consortium; and his institution is receiving a grant from the Department of Defense. Dr. P. Tornetta III is salaried and supported by publication royalties from Smith & Nephew and Wolters Kluwer/Lippincott William & Wilkins; holds the intellectual property rights/patent & royalties from Smith & Nephew; receives consulting fees from Smith & Nephew. Dr. J. Ahn receives consulting fees from AO and Synthes; and his institution is currently receiving a grant from the Department of Defense. Dr. A. Schmidt is a current board member of the Orthopaedic Trauma Association; receives consulting and lecture fees from Medtronic, Inc; and his institution is currently receiving a grant from the Department of Defense. Dr. R. Probe certifies that he has or may receive payments or benefits from Stryker Orthopaedics, Mahwah, NJ, USA. Dr. R. Probe is on the Board of Trustees of Scott & White Healthcare and Chair, Board of Directors of Scott & White Memorial Hospital. The remaining authors report no conflict of interest. The project described was supported by the National Center for Research Resources, Grant UL1 RR024975-01, and is now at the National Center for Advancing Translational Sciences, Grant 2 UL1 TR000445-06. The content is solely the responsibility of the authors and does not necessarily represent the official views of the NIH.
Publisher Copyright:
Copyright © 2013 by Lippincott Williams & Wilkins.
Keywords
- Segmental long bone defects