Today's perspectives and challenges in moving management of patients with open tibial fractures forward in the Netherlands.
Early soft tissue coverage for open tibial fractures is rarely achieved.
Today's perspectives and challenges in moving management of patients with open tibial fractures forward in the Netherlands.
Management of open crural fractures is challenging and requires close interdisciplinary collaboration.
This study assessed current practice in the Netherlands regarding case volume, organization of care and timing of procedures, while also exploring barriers and facilitators for fracture fixation and soft tissue closure (fix and flap) within 72 h.
A national survey was conducted among plastic and orthopedic trauma surgeons, covering January-December 2024.
All 11 of the level 1 centers in the Netherlands responded, in addition we got a response from 13 specialists working in level 2 centers.
Eighteen Orthopedic trauma surgeons and 24 plastic surgeons responded.
In 63% of centers, at least 10 open tibial fractures were managed annually; 28% reported treating over 20 open tibial fractures per year.
Although 59% of respondents regarded early soft tissue coverage sufficiently supported by evidence, numerous barriers were identified, including limited theater availability and inadequate prioritization of open fractures.
Soft tissue coverage within 72 h for open tibial fractures is rarely achieved, mainly due to limited theater availability and prioritization issues.
Differences in orthopedic trauma- and plastic surgeons' perspectives highlight coordination challenges. Reserved theater time, stronger evidence, and centralization of care could improve adherence.
As early soft tissue coverage may reduce complications, hospital stay, and costs, our results warrant further research and active implementation.