![]() Each article was evaluated independently by three members of the committee to extract pertinent data. A systematic review of the literature was then conducted to identify relevant articles. The five highest rated outcomes were selected as follows: mortality, infection, VTE, nonunion/malunion, and amputation. Eight panelists independently rated the relative importance of each outcome on a 9-point scale ranging from 1 (less important) to 9 (critically important for decision making). Outcome Measure TypesĪn initial list of all relevant outcomes (infection, nonunion/malunion, compartment syndrome, VTE, fat embolism syndrome, regional pain, neurologic impairment, arthritis, hardware failure, impaired function, mortality, or amputation) was generated and distributed to panelists. We included studies comparing open reduction and internal fixation performed within 24 hours from the time of injury to stabilization performed greater than 24 hours after injury. Meta-analyses, case reports, letters, and reviews containing no original data or comments were excluded. We included studies with adult patients, any sex, and with no restriction on inclusion of ethnicities or patients with comorbidities. Only studies pertaining to open reduction and internal fixation of open or closed femur fractures were included. Inclusion Criteria For This Review Study Typesįor the purpose of making recommendations, studies included randomized controlled trials (RCTs), prospective observational or retrospective studies, and case-control studies. Outcomes: mortality, infection, nonunion/malunion, amputation, VTE.Comparator: open reduction and internal fixation greater than 24 hours after injury.Intervention: open reduction and internal fixation within 24 hours of injury.Population: trauma patients with an open or closed femur fracture.The objective of this guideline was to evaluate the comparative effectiveness of early (24 hours) open reduction and internal fixation of an open or closed femur fracture in trauma patients, particularly in preventing mortality, infection, nonunion/malunion, amputation, and venous thromboembolism (VTE). ![]() Overton, MPH, JPS Health Network, Trauma Services, 1500 S Main St, Fort Worth, TX email: Objectives This study was part of the podium presentation at the 2014 EAST Conference.Īddress for reprints: Tiffany L. MD Shafi, Shahid MD Author Informationįrom the Department of Surgery (R.R.G., T.L.O., S.S.), JPS Health Network, Fort Worth and Department of Surgery (D.A.), East Texas Medical Center, Tyler, Texas Departments of Surgery (E.R.H., B.L.), and Orthopaedic Surgery (E.H.), The Johns Hopkins University School of Medicine, Baltimore, Maryland Department of Orthopaedics (H.A.V.), MetroHealth, Cleveland, Ohio Department of Surgery (T.R.), Borgess Health, Kalamazoo, Michigan Department of Surgery (J.K.L.), Advocate Medical Group, Chicago, Illinois Department of Surgery (J.W.), Oregon Health and Science University, Portland, Oregon and Department of Trauma and Acute Care Surgery (F.B.R.), Lancaster General Health, Lancaster, Pennsylvania. MD Rohs, Thomas MD Hasenboehler, Erik MD Lee, Jane Kayle MD Alley, Darrell MD Watters, Jennifer MD Rogers, Frederick B. ![]() MD, PhD Lau, Brandyn MPH Vallier, Heather A. Exempt Purpose, Mission, Vision & Goals.Interviews with Research Scholarship & Award Recipients.Injury Control and Violence Prevention Resources. ![]()
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