{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,2]],"date-time":"2026-08-02T07:05:59Z","timestamp":1785654359231,"version":"3.56.0"},"reference-count":16,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"6","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2021,6]]},"abstract":"<jats:sec>\n            <jats:title>Objectives:<\/jats:title>\n            <jats:p>To correlate domains of the Orthopaedic Trauma Association Open Fracture Classification (OTA-OFC) in open upper extremity injuries with type of definitive soft-tissue closure, complication rates, and unanticipated return to the operating room for complication.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Design:<\/jats:title>\n            <jats:p>Retrospective review of prospectively collected data.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Setting:<\/jats:title>\n            <jats:p>Level I trauma center.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Patients:<\/jats:title>\n            <jats:p>Two hundred thirty-four consecutive open upper extremity fractures.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Intervention:<\/jats:title>\n            <jats:p>Operative management of open upper extremity fractures.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Main outcome measurements:<\/jats:title>\n            <jats:p>Type of definitive closure, 90-day wound complication, and wound complication necessitating return to the operating room.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results:<\/jats:title>\n            <jats:p>Two hundred eighty injuries were identified, and 234 had sufficient data for analysis. Eighty-four percent (196\/234) of open wounds were closed primarily, 7% (16\/234) required a skin graft, and 4% (9\/234) required rotational or free flap. Thirteen percent (22\/166) of those followed for 90 days had a wound complication, and 50% of those with complication required a return to the OR. All OTA-OFC classifications statistically significantly correlated with type of closure (<jats:italic toggle=\"yes\">P<\/jats:italic> &lt; 0.001), with skin having a high correlation (r = 0.79), muscle (r = 0.49) and contamination (r = 0.47) moderate correlations, and arterial (r = 0.32) and bone loss (r = 0.33) low correlations. OTA-OFC muscle classification was predictive of 90-day wound complication (OR 0.31, 95% confidence interval 0.07\u20130.21). OTA-OFC domains correlated variably with return to the OR.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusion:<\/jats:title>\n            <jats:p>OTA-OFC clinically correlates with definitive wound management and 90-day wound complication in open upper extremity fractures. OTA-OFC skin classification has a high correlation with the type of definitive wound closure. OTA-OFC muscle was the only domain that correlated with 90-day wound complication and was predictive of 90-day wound complication.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Level of Evidence:<\/jats:title>\n            <jats:p>Prognostic Level III. See Instructions for Authors for a complete description of levels of evidence.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1097\/bot.0000000000001986","type":"journal-article","created":{"date-parts":[[2020,10,20]],"date-time":"2020-10-20T18:01:55Z","timestamp":1603216915000},"page":"e184-e188","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":3,"title":["Clinical Correlation of the Orthopaedic Trauma Association Open Fracture Classification With Wound Closure and Soft-Tissue Complications in Open Upper Extremity Fractures"],"prefix":"10.1097","volume":"35","author":[{"given":"Sara M.","family":"Putnam","sequence":"first","affiliation":[{"name":"Department of Orthopaedic Surgery, University of Nebraska Medical Center, 985640 Nebraska Medical Center, Omaha, NE;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jacquelyn","family":"Dunahoe","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Harborview Medical Center, Seattle, WA; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julie","family":"Agel","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Harborview Medical Center, Seattle, WA; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthew R.","family":"Garner","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery and Rehabilitation, Penn State College of Medicine, Milton S. Hershey Medical Center, 500 University Drive, Hershey, PA."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"R1-20250614","doi-asserted-by":"crossref","first-page":"1320","DOI":"10.1001\/archsurg.1988.01400350034004","article-title":"Risk of infection after open fracture of the arm or leg","volume":"123","author":"Dellinger","year":"1988","journal-title":"Arch Surg."},{"key":"R2-20250614","doi-asserted-by":"crossref","first-page":"453","DOI":"10.2106\/00004623-197658040-00004","article-title":"Prevention of infection in the treatment of one thousand and twenty-five open fractures of long bones: retrospective and prospective analyses","volume":"58","author":"Gustilo","year":"1976","journal-title":"J Bone Joint Surg Am."},{"key":"R3-20250614","doi-asserted-by":"crossref","first-page":"651","DOI":"10.1007\/s00068-016-0725-y","article-title":"The Gustilo-Anderson classification system as predictor of nonunion and infection in open tibia fractures","volume":"43","author":"Thakore","year":"2017","journal-title":"Eur J Trauma Emerg Surg."},{"key":"R4-20250614","doi-asserted-by":"crossref","first-page":"484","DOI":"10.1097\/00005131-200208000-00006","article-title":"The effect of time to definitive treatment on the rate of nonunion and infection in open fractures","volume":"16","author":"Harley","year":"2002","journal-title":"J Orthop Trauma."},{"key":"R5-20250614","first-page":"352","article-title":"Open tibia fractures: timely debridement leaves injury severity as the only determinant of poor outcome","volume":"70","author":"Enninghorst","year":"2011","journal-title":"J Trauma."},{"key":"R6-20250614","doi-asserted-by":"crossref","first-page":"1057","DOI":"10.2106\/JBJS.K.00582","article-title":"Does timing to operative debridement affect infectious complications in open long-bone fractures? 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A retrospective observational cohort study on 512 patients","volume":"30","author":"Hao","year":"2016","journal-title":"J Orthop Trauma."},{"key":"R14-20250614","doi-asserted-by":"crossref","first-page":"579","DOI":"10.1097\/BOT.0000000000000648","article-title":"An evaluation of the OTA-OFC system in clinical practice: a multi-center study with 90 Days outcomes","volume":"30","author":"Johnson","year":"2016","journal-title":"J Orthop Trauma."},{"key":"R15-20250614","doi-asserted-by":"crossref","first-page":"300","DOI":"10.1097\/BOT.0b013e3182a70f39","article-title":"Potential predictive ability of the orthopaedic trauma association open fracture classification","volume":"28","author":"Agel","year":"2014","journal-title":"J Orthop Trauma."},{"key":"R16-20250614","doi-asserted-by":"crossref","first-page":"9","DOI":"10.1016\/j.hcl.2017.09.001","article-title":"Antibiotic management and operative debridement in open fractures of the hand and upper extremity: a systematic review","volume":"34","author":"Warrender","year":"2018","journal-title":"Hand Clin."}],"container-title":["Journal of Orthopaedic Trauma"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.lww.com\/10.1097\/BOT.0000000000001986","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,6,14]],"date-time":"2025-06-14T19:03:25Z","timestamp":1749927805000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.lww.com\/10.1097\/BOT.0000000000001986"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,6]]},"references-count":16,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2021]]}},"URL":"https:\/\/doi.org\/10.1097\/bot.0000000000001986","relation":{},"ISSN":["0890-5339"],"issn-type":[{"value":"0890-5339","type":"print"}],"subject":[],"published":{"date-parts":[[2021,6]]},"assertion":[{"value":"2020-10-13","name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}}]}}