The Journal of Bone and Joint Surgery, Vol 57, Issue 8 1065-1070, Copyright © 1975 by Journal of Bone and Joint Surgery, Inc
The early management of open joint injuries. A prospective study of one hundred and forty patients
MJ Patzakis, LD Dorr, D Ivler, TM Moore and JP Harvey
A study of open joint injuries treated at the Los Angeles County-University
of Southern California Medical Center from July 1969 through July 1973
showed that the vast majority of these injuries were at the knee. Three
types of injury were identified: those associated with fractures, injuries
without fracture, and gunshot wounds. All patients were treated with
antibiotics, surgical debridement and irrigation, and installation of
polyethylene tubes into the joint as a system of postoperative closed
irrigation. The over-all infection rate was 2.1 per cent. The results of
treatment indicate that the irrigation system can be a source of
contamination. Our recommended treatment for open wounds in joints is
wide-spectrum systemic antibiotics, surgical debridement, irrigation of the
joint and soft tissues, and primary closure. Prolonged suction-irrigation
treatment postoperatively should only be done for specific indications:
excessive contamination or excessive tissue damage when the wound to the
joint should be closed primarily.
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