Tribble DR, et al. - Researchers evaluated osteomyelitis risk factors in US military personnel with combat-related open tibia fractures (2003–2009). Participants were patients with open tibia fractures who met the diagnostic criteria of osteomyelitis (cases) and those with open tibia fractures who did not meet osteomyelitis criteria (controls). The highest risk for osteomyelitis was seen in patients with severe blast trauma resulting in significant muscle damage. The factors that showed significant relations to osteomyelitis development were blast injuries, antibiotic bead utilization, ≥ Gustilo–Andersen-IIIb fractures, and foreign body at the fracture site. The period association coincided with a time frame when several trauma system practice changes were initiated (eg, increased negative pressure wound therapy, decreased high-pressure irrigation, and reduced crystalloid use).