A study from the Royal Infirmary of Edinburgh, United Kingdom, found that while open foot fractures are uncommon, they led to a high rate of amputation for those with more severe injury.
Researchers reviewed 23 years of patient records from a hospital with a service area of 530,000 adults to determine the incidence of open foot fractures. After establishing that 348 open foot fractures were treated in that time, and that only 13 percent were in patients 65 or older, the type of fractures were than categorized into three levels of severity.
Level I injuries were isolated open forefoot fractures and occurred in 69 percent of patients.
Patients with multiple forefoot fractures had a higher Injury Severity Score (ISS), a higher prevalence of Gustilo type III fractures (fractures with extensive soft tissue damage, often caused by a high-velocity or crushing injury). The most severely injured patients, those with level III open hindfoot and midfoot fractures, had an average ISS of 12 (major trauma is 15) and 65.9 percent had Gustilo type III fractures. The amputation rate for patients in this group who presented with open hindfoot fractures was 17.1 percent, and rose to 30 percent for those patients with open midfoot fractures.
Complete details can be found in the March edition of the journal Foot and Ankle International.
