ABSTRACT
PURPOSE: We sought to conduct the largest retrospective study to date of open tibia fractures and describe the incidence of complications and evaluate the potential predictive risk factors for complications. METHODS: Patients with open tibia fractures treated with reamed intramedullary nail (IMN) across a 10-year period were evaluated. Patient charts were reviewed for demographics, type of open fracture (T), comorbidities, and postoperative complications. A multivariate model was conducted to determine the risk factors for each type of complication. RESULTS: Of the 486 patients with open tibia fractures, 13 % (n = 64) had infections, 12 % (n = 56) had nonunions, and 1 % (n = 7) had amputations. TIII fractures had much higher rates of each complication than TI and TII fractures. Fracture type was the only significant risk factor for both nonunion and infection. CONCLUSION: Our study found that the Gustilo grade of open tibia fracture is by far the greatest predictor of nonunion and infection.
Subject(s)
Fractures, Ununited/surgery , Injury Severity Score , Tibial Fractures/surgery , Adolescent , Adult , Aged , Aged, 80 and over , Databases, Factual , Female , Fracture Fixation, Intramedullary , Fracture Healing , Fractures, Ununited/diagnostic imaging , Fractures, Ununited/pathology , Humans , Incidence , Male , Middle Aged , Postoperative Complications/epidemiology , Predictive Value of Tests , Retrospective Studies , Risk Factors , Surgical Wound Infection/epidemiology , Tibial Fractures/diagnostic imaging , Tibial Fractures/pathology , United States/epidemiology , Young AdultABSTRACT
DNA vaccines have been widely used as effective means of eradicating a variety of viruses, parasites, bacteria as well as means of alleviating allergic and autoimmune diseases and tumors. As interleukin 1 (IL-1) plays an essential role in augmenting both cellular and humoral immune responses to foreign antigens, it may represent a good candidate for an adjuvant to DNA vaccines. Since the inflammatory activity of IL-1 may have a restricted application to DNA vaccines, we explored the possibility of augmenting immune response without unwanted inflammatory effect using IL-1beta 163-171 peptide, which is essential for IL-1 receptor 1 binding. A DNA fragment encoding the human IL-1beta 163-171 peptide of concern was fused to the Hepatitis B virus (HBV) core DNA vaccine, and injected into mice to analyze its immune responses. Compared with the control mice which received hepatitis B virus core antigen (HBcAg) alone, significant increase in not only the HBcAg-specific antibody response but also in T cell proliferation was observed in mice which received IL-1beta 163-171-HBcAg. These results suggest that the DNA fragment encoding the IL-1beta polypeptide of aa 163-171 might represent a good candidate for an adjuvant of DNA vaccines.
