Frequency of chronic osteomyelitis in open tibia fracture treated by external fixator at tertiary care hospital.

Abstract

Objective: To determine the frequency of chronic osteomyelitis and associated factors in open tibia fractures treated with an external fixator at a tertiary care hospital. Study Design: Descriptive Cross-sectional study. Setting: Department of Orthopedic, Dr. Ruth K. M. Pfau Civil Hospital / DUHS. Period: May 2025 to Oct 2025. Methods: A total of 121 patients, aged 18–60 years, with open tibial fractures treated using external fixators, were enrolled consecutively. The subjects' data on sociodemographic characteristics, fracture details, and treatment-related variables were recorded on a standardized proforma. Patients were followed, and chronic osteomyelitis was diagnosed based on predefined clinical, radiological, and microbiological criteria. Data entry and analysis were done using the SPSS version 27.0.1. Descriptive statistics were employed, while associations were determined using the chi-square test; with a p value of less than 0.05 was regarded as statistically significant. Results: Chronic osteomyelitis developed in 12.4% of patients. Smoking, higher Gustilo–Anderson fracture grades (IIIB/IIIC), proximal tibial fracture location, and primary wound closure were independently associated with infection. Smoking showed the strongest association, markedly increasing the risk of chronic osteomyelitis while gender was not a significant predictor after adjustment. Conclusion: Chronic osteomyelitis remains a significant complication following open tibial fractures managed with external fixation. Injury severity and modifiable factors such as smoking and wound-closure strategy play a crucial role in infection development. Implementing strategies for managing wounds and associated risk factors can potentially decrease infectious complications.