Journal article
The Open-Fracture Patient Evaluation Nationwide (OPEN) study: epidemiology of open fracture care in the UK
- Abstract:
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Aims
Understanding of open fracture management is skewed due to reliance on small-number lower limb, specialist unit reports and large, unfocused registry data collections. To address this, we carried out the Open Fracture Patient Evaluation Nationwide (OPEN) study, and report the demographic details and the initial steps of care for patients admitted with open fractures in the UK.Methods
Any patient admitted to hospital with an open fracture between 1 June 2021 and 30 September 2021 was included, excluding phalanges and isolated hand injuries. Institutional information governance approval was obtained at the lead site and all data entered using Research Electronic Data Capture. Demographic details, injury, fracture classification, and patient dispersal were detailed.Results
In total, 1,175 patients (median age 47 years (interquartile range (IQR) 29 to 65), 61.0% male (n = 717)) were admitted across 51 sites. A total of 546 patients (47.1%) were employed, 5.4% (n = 63) were diabetic, and 28.8% (n = 335) were smokers. In total, 29.0% of patients (n = 341) had more than one injury and 4.8% (n = 56) had two or more open fractures, while 51.3% of fractures (n = 637) occurred in the lower leg. Fractures sustained in vehicle incidents and collisions are common (38.8%; n = 455) and typically seen in younger patients. A simple fall (35.0%; n = 410) is common in older people. Overall, 69.8% (n = 786) of patients were admitted directly to an orthoplastic centre, 23.0% (n = 259) were transferred to an orthoplastic centre after initial management elsewhere, and 7.2% were managed outwith specialist units (n = 81).Conclusion
This study describes the epidemiology of open fractures in the UK. For a decade, orthopaedic surgeons have been practicing in a guideline-driven, network system without understanding the patient features, injury characteristics, or dispersal processes of the wider population. This work will inform care pathways as the UK looks to the future of trauma networks and guidelines, and how to optimize care for patients with open fractures.
- Publication status:
- Published
- Peer review status:
- Peer reviewed
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- Files:
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(Preview, Version of record, pdf, 778.6KB, Terms of use)
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- Publisher copy:
- 10.1302/2633-1462.310.bjo-2022-0079.r1
Authors
Contributors
- Role:
- Contributor
- Institution:
- University of Oxford
- Division:
- MSD
- Department:
- NDORMS
- Role:
- Contributor
- Publisher:
- British Editorial Society of Bone and Joint Surgery
- Journal:
- Bone & Joint Open More from this journal
- Volume:
- 3
- Issue:
- 10
- Pages:
- 746-752
- Place of publication:
- England
- Publication date:
- 2022-10-01
- DOI:
- EISSN:
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2633-1462
- Pmid:
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36181319
- Language:
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English
- Keywords:
- Pubs id:
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1281493
- Local pid:
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pubs:1281493
- Deposit date:
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2024-05-14
Terms of use
- Copyright holder:
- Hadfield et al.
- Copyright date:
- 2022
- Rights statement:
- © 2022 Author(s) et al. This is an open-access article distributed under the terms of the Creative Commons Attribution Non-Commercial No Derivatives (CC BY-NC-ND 4.0) licence, which permits the copying and redistribution of the work only, and provided the original author and source are credited.
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