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Advances in Orthopedics
Volume 2011, Article ID 943495, 4 pages
Clinical Study

Infection Rates in Open Fractures of the Tibia: Is the 6-Hour Rule Fact or Fiction?

Department of Orthopaedic Surgery, Wellington Public Hospital, 8D/39 Taranaki Street, Te Aro, Wellington 6011, New Zealand

Received 7 June 2011; Revised 28 July 2011; Accepted 22 August 2011

Academic Editor: Robert F. Ostrum

Copyright © 2011 Ameya S. Kamat. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Aims. Emergency debridement has long been the standard of care for open fractures of the tibia as infection is an important complication. The timing of operative debridement can be debated. We review open fractures of the tibia and compare infection rates in those that were operated on within and after 6-hours. Method. 103 consecutive open fractures of the tibia were reviewed. The data was analysed retrospectively with regard to severity of fracture and incidence of infection. Infection rates over a three-month period were compared between the two groups. Results. 12 (11.6%) patients developed an infection within the first 3 months of injury. 7 of which were taken to theatre within 6-hours, and 5 after 6-hours. No significant differences were found between these two groups. Conclusion. There is no significant difference in timing of surgery. Initial basic interventions may play more of a role in limiting the risk of infection.