When a person suffers an open tibial fracture, where the shin bone breaks and pierces the skin, it is a medical emergency. These injuries expose the bone and surrounding tissue to bacteria, increasing the risk of infection and long-term complications.

A recent study co-authored by Dr Jobe Shatrov, published in the European Journal of Orthopaedic Surgery & Traumatology, examined whether delay to surgical debridement (thorough cleaning of the wound and removal of damaged tissue) affects infection risk and outcomes.
Read the full paper: https://rdcu.be/es5qN

What the study investigated

The research reviewed patients with open tibial fractures treated at a major trauma centre and asked:

• Does earlier surgical debridement reduce infection rates?

• Is there a time window that matters most?

• What are the outcomes when debridement is delayed?

Patients were grouped by time to surgery, and outcomes such as deep infection and need for further procedures were tracked.

Key findings

Patients who underwent surgical debridement within recommended timeframes had lower rates of deep infection and better overall outcomes. Delays were associated with higher infection risk, particularly deep infection that can threaten limb function and, in severe cases, limb salvage.

In practical terms, the sooner the wound is surgically cleaned and stabilised, the lower the risk of complications such as osteomyelitis, wound breakdown, persistent pain, and the need for further surgery.

Why this matters for patients

Open fractures are not “wait and see” injuries. Early hospital assessment and timely surgery are crucial. This study reinforces current best practice:

• Seek urgent care at a hospital, ideally a major trauma centre.

• Early antibiotics and prompt surgical debridement reduce infection risk.

• Appropriate fracture stabilisation and wound care support recovery.

How open tibial fractures are treated

Treatment usually involves:

1. Initial stabilisation and urgent antibiotics.

2. Surgical debridement to remove contaminated or non-viable tissue.

3. Fracture stabilisation with external fixation or internal fixation, depending on the injury pattern.

4. Soft-tissue management, sometimes with plastic surgery input for coverage.

5. Ongoing wound care, rehabilitation, and infection surveillance.

Some injuries require staged procedures, bone grafting, or soft-tissue reconstruction depending on severity.

Signs of infection to watch for after surgery

Contact your surgical team immediately if you notice:

• Increasing redness, swelling, or warmth around the wound

• Fever or chills

• Wound discharge, especially if pus-like or foul-smelling

• Worsening pain or persistent fatigue

• Difficulty weight-bearing beyond what your surgeon advised

Early review can prevent complications and protect the outcome of your surgery.

About the research

This work reflects collaboration between orthopaedic trauma surgeons and researchers at Royal North Shore Hospital, with Dr Shatrov as a co-author. The findings help refine hospital protocols and support evidence-based decisions that improve patient safety and recovery.

Read the full paper: https://rdcu.be/es5qN

Learn more

• Orthopaedic trauma and fracture management

• Infection prevention after surgery

• About Dr Jobe Shatrov