THE CONTRIBUTION OF OPEN EXTREMITY FRACTURES TO INFECTION IN MULTIPLYINJURED PATIENTS

We sought to determine whether a contaminated open fracture was a reli able component for calculating the Outcome Predictive Score in patient s with multiple injuries. We studied 41 patients whose primary source of contamination was open extremity fractures. Only one of the 41 pati ents developed osteomyelitis. The rate of infection from an open fract ure is minimal in the multiply injured patient. Inclusion of patients with open fractures in studies that assess the likelihood of infection and the value of anti-infective agents incorrectly identified patient s for clinical trials and results in an overestimation of survival bas ed on the Outcome Predictive Score. These findings suggest that open f ractures should be excluded as an entry criterion in future clinical t rials.