Evaluation of new scoring system predicting the occurrence of deep infection in open fractures patients

Khaled Morsy Salama, Ahmed Abdelbadie Abdallah, Yassin Mohamed Sakr Alghoul, Mohamed Saleh Mostafa, Elsayed Abdallah Elsayed Zied


Background: Open fractures of long bones incidence is 11.5 per 100,000 person per year. The management of open fractures had been improved by early adequate surgical debridement and various types of fracture fixation. The Gustilo classification is commonly used for treatment decisions and comparison. Although it had a good prediction power for deep infection but the variability among the inter observer was a problem. Yokoyama et al., 2009 he had advised a new scoring system based on three items of HFS-98 to predicting significant deep infections in open upper and lower extremity fractures.

Methods: This study was conducted at Emergency Department Suez Canal University Hospital on 233 Patients with open fractures of long bones from April 2014 till November 2015. The patients were classified according to the criteria proposed by Gustilo classification & Yokoyama’s new scoring system. The relationship between the new score three items were investigated by categorical regression multivariate analysis.

Results: In this study, we had 233 Patients with open fractures of long bones. Road traffic accidents were the mechanism of injury in (44.6%). Deep infection was positive in 70/233 patients with Gustilo GI. The cut-off point of application of Yokoyama’s new scoring system was 30, Sensitivity; 63.3%, Specificity; 89%, significant P-value <0.001.

Conclusions:The cut-off point of the new Yokoyama’s new scoring application in this study was slit different from the reported applicable values before. This revised scoring system was thought to be useful for predicting deep. Further prospective trial is needed for advising new scoring system.



Deep infection, New score system, HFS-98, Open fractures of long bones

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