Gas Gangrene in Orthopaedic Patients

Table 1

Gas gangrene infections in traumatic orthopaedic patients.

Source	Cause	Age	Fracture	Soft tissue	Pathogen	Outcome
Fee, 1977 [5]	Fall from a tree	8	Closed, forearm	A small laceration	Gram-positive Spore-forming rods	Lived with disarticulation
	Fall from a tree	10	Open, right forearm	Two small lacerations	Clostridium perfringens	Lived with amputation
	Fall from a tree	11	Open, right forearm	A puncture wound	Clostridium perfringens	Lived with amputation
	Fall from a roof	12	Open, right forearm	Two openings	Clostridium perfringens	Lived with preserved forearm
	Fall on the street	52	Open, left radius	A puncture wound	Gram-positive rods	Lived with amputation
Buchanan and Gordon, 1980 [6]	Fall from 5 stories	19	Compound fracture of right tibia and fibula	Contaminated with dirt, gravel	Clostridium perfringens	Lived with amputation
Fulford, 1969 [7]	Traffic accident	19	Open, right femur	Contaminated, No detail	Unknown	Lived with preserved limb
Lucas et al., 1976 [8]	Kicked on right shin in a tackle	24	Tibia and fibula	7 cm wound	Clostridium septicurn	Lived with preserved limb
Woolley et al., 2004 [9]	Fall from high place	39	Open, left tibia, and fibula	Gustillo Grade III	Clostridium septicurn (no gas gangrene)	Lived with preserved limb
Werry and Meek, 1986 [10]	Unknown	32	Distal radius	Abrasion of the volar wrist skin	Clostridium perfringens	Lived with amputation
Goon et al., 2005 [11]	Local accident	76	No fracture	No traumatic history	Clostridium septicurn	Died
Taylor et al., 2011 [12]	High-speed motor vehicle collision	21	Closed, right femur with traction pin	Multiple organ injuries	Clostridium perfringens	Died
Mulier et al., 1993 [13]	Fall from a height of 8 feet	45	Closed, femoral fracture	Unknown	Clostridium septicurn	Survived with disarticulation
Lorea et al., 2004 [14]	Muscle transfer for opponensplasty	49	No fracture	Normal muscle surgery	Clostridium perfringens, Sordellii	Survived with preserved forearm
Sevitt, 1953 [15]	Playing football	26	Closed, left ankle	Unknown	Clostridium perfringens	Survived with amputation
HILL, 1959 [16]	Fall from a gate	6	Left forearm fracture	A small wound on the forearm	Unknown	Survived with amputation
Aufranc et al., 1969 [17]	Struck by a rotating truck wheel	29	Open, right tibia	Wringer-type injury of leg.	Presence of gram-positive rods	Survived with preserved limb
	Automobile accident	13	Compound, left tibia, and fibula	Unknown	Bacilli welchii	Died
	Fall from window to ground	24	Compound, left tibia	Unknown	Bacilli welchii	Survived with amputation
	Automobile accident	37	Compound, left tibia, and fibula	Unknown	Bacilli welchii	Died
	Hooked by a cow	6	Compound, right forearm	Unknown	Bacilli welchii	Survived with amputation
Boland, 1929 [18]	Street accident	52	Compound, left tibia, and fibula	Unknown	Positive culture, detail Unknown	Survived with amputation
	Truck Accident	21	Compound, left tibia, and fibula	Unknown	Positive culture, detail Unknown	Survived with preserved limb
	Motorcycle accident	18	Compound, right tibia, and fibula	Unknown	Bacilli welchii	Survived with amputation
	Struck by a truck	5	Compound, upper extremity, left femur, left tibia, and fibula	Unknown	Bacilli welchii	Died
	Street-car accident	13	Compound, both legs	Unknown	Bacilli welchii	Died
	Knee joint fracture from gun-shot	30	Knee joint fracture	Unknown	Positive culture, detail Unknown	Survived with amputation
	Auto accident	36	Compound, right tibia, and fibula	Unknown	Positive culture, detail Unknown	Survived with amputation
	Falling from freight train	16	Compound, both legs	Unknown	Positive culture, detail Unknown	Survived with amputation
	Motorcycle accident	40	Compound, left tibia, and fibula	Unknown	Positive culture, detail Unknown	Survived with preserved limb
	Automobile accident	25	Compound, both legs	Unknown	Positive culture, detail Unknown	Died
	Gun-shot	20	Compound, right ulnar, and radius	Unknown	Negative culture	Died
Brume and Ijagha, 1985 [19]	Unknown	9	Closed Colles’ Fracture	Unknown	Unknown	Survived with amputation
	Unknown	27	Closed, medical malleolus	Unknown	Unknown	Survived with amputation
	Unknown	30	Closed,tibia and fibula	Unknown	Unknown	Died
	Unknown	14	Closed Colles’ Fracture	Unknown	Unknown	Survived with amputation
Moehring, 1988 [20]	Automobile accident	13	Right ankle region	Marked soft tissue swelling	Clostridium perfringens	Lived with preserved limb
Oncel and Arsoy, 2010 [21]	Nail pierced the skin of hand	16	No fracture	A small wound on the hand	Gram-positive rods	Survived with amputation
Hoffman et al., 1971 [22]	Working accident	25	Tibia fracture	Muscle and skin lacerated	Clostridium welchii	Survived
DeHaven and Evarts, 1971 [23]	Fall from horseback	10	Open, both bones of forearms	Mild damage of soft tissue	Clostridium perfringens	Survived with amputation
	Automobile accident	44	Open, Bilateral tibia, and fibulae	Damaged and contaminated severely	Pseudomonas, Klebsiella et al.	Survived with amputation
	Automobile accident	21	Open, pelvic	Multiple	Clostridium perfringens	Survived
	Fall from running	10	Open, both bones of forearms	Mild damage of soft tissue	Clostridium perfringens	Survived with amputation
	Automobile accident	19	Open, tibia, and fibula	Severe damage of soft tissue	Bacillus subtilis, Proteus	Survived with amputation
Johnson et al., 1994 [24]	Arthroscopic knee surgery	36	No fracture	No	Clostridium Septicum	Survived with amputation
	Hip Arthroplasty	57	No fracture	No	Clostridium Septicum	Survived
Dykes, 1977 [25]	Hip nailing	71	Transcervical fracture of femur	No	Clostridium welchii	Died
	Hip nailing and plate fixation	68	Subtrochanteric fracture of femur	No	Unknown	Died
	Hip nailing	79	Transcervical fracture of femur	No	Unknown	Died
Miller et al., 1993 [26]	Iliac crest bone graft transplantation	55	Nonunion of closed fracture of clavicle	No	Clostridium perfringens	Survived

(1) Compound fracture indicates open fracture, while simple fracture means closed fracture.
(2) Bacillus welchii is another expression of Clostridium perfringens.
(3) Clostridium perfringens (formerly known as C. welchii).