An Evaluation of the OTA-OFC System in Clinical Practice: A Multi-Center Study With 90 Days Outcomes

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The purpose of this study is to evaluate the predictive ability of the Orthopedic Trauma-Open Fracture Classification (OTA-OFC) system in regards to short-term (90 days) outcomes of amputation, infection necessitating intravenous antibiotics, and wound healing in clinical practice across multiple centers.


Prospective observational study.


Academic and private practice.


Patients with open fractures.



Main Outcome Measurements:

OTA-OFC, amputations, IV antibiotics, and wound healing.


Three hundred seventy-three patients with a total of 419 open fractures were enrolled. Logistic regression to predict amputation demonstrated that arterial and skin injury were statistically significant contributors to the prediction of amputation. Bone loss and muscle injury were significant contributors to the prediction of readmission for IV antibiotics. None of the variables in the OTA-OFC were significant predictors of unhealed wounds.


Our study demonstrates the predictive value of the OTA-OFC regarding the short-term (90 days) outcomes of amputation and infection necessitating IV antibiotics and is another step towards the validation of the OTA-OFC in widespread clinical practice.

Level of Evidence:

Prognostic Level I. See Instructions for Authors for a complete description of levels of evidence.

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