The use of qualitative cultures for detecting infection in open tibial fractures.

PURPOSE To determine the role of qualitative cultures for detecting infection in open tibial fractures. METHODS From January 2003 to December 2004, 95 men and 13 women (mean age, 34 years) with open tibial fractures in one or both limbs and without any other sites of infection were prospectively studied. Patients who had been treated with intravenous or oral antibiotics before presentation and/or had undergone debridement or other surgery were excluded. RESULTS Infection was not correlated with age, sex, interval from injury to debridement, and cause of fracture. The association of infection with predebridement cultures was stronger (odds ratio=12.5) than that with postdebridement cultures (odds ratio=4.7). CONCLUSION Pre- and post-debridement cultures have a role in detecting infection in open tibial fractures. For detecting infection, predebridement cultures have better sensitivity, while postdebridement cultures have better specificity.