Fracture and Wound Healing of Closed Femoral Shaft Fracture in HIV-Positive Patients at King Narai Hospital, Lop Buri

Abstract

This prospective study was aimed at studying fracture and wound healing of closed femoral
shaft fracture in HIV-positive patients, and normal population. The sampling was conducted at King
Narai Hospital, Lop Buri, between January 1, 2009, and March 31, 2012. There were 31 individuals
living with HIV and 34 in a control group selected from normal population. The type and nature of
data collected included the following: body mass index, biological markers of HIV infection, radiological
study in term of time of fracture healing, degree of abrasion wound, stage of contusion,
asepsis wound scoring system, and others. Statistical analyses descriptive, and analytical statistics
(independent t-test) were used to compare the time of fracture healing and wound healing between
the HIV-positive patients and the control group.
The finding revealed that the time difference of fracture healing between the HIV-positive
patients and the control group was statistically significant at p < 0.05 (Mean, SD 28.58, 4.87, and
24.82, 1.49 weeks, respectively). Conversely, difference of asepsis wound scoring system in both
groups was not statistically significant at p < 0.05 (Mean, SD 1.32, 0.48 and 1.47, 0.51, respectively).
This study suggests that fracture healing time was significantly delayed in the HIV- positive
patients due to decreased bone mineral density that full length of bone healing time was 40 weeks.
Abrasion stage, severity of contusion and mostly CD4 cell count less than 200 cells/μL in HIVpositive
patients notably increased the risk of wound infection that affected the healing process.
Therefore, orthopaedic surgeons must also be responsible for managing fracture and wound healing
in HIV-positive patients, especially who had CD4 cell count less than 200 cells/μL.
Key words: fracture healing, closed femoral shaft fracture, HIV-positive patients