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At least 217 records · Page 12Linked to original sources
PubMed1999

Once daily, high dose versus divided, low dose gentamicin for open fractures.

A prospective, randomized study was performed on 75 Gustilo Grades II and III open fractures to determine the efficacy of once daily, high dose aminoglycoside therapy, compared with more conventional dosing, in reducing the infection rate when used in conjunction with an aggressive operative treatment protocol. All patients enrolled in the study were treated with immediate irrigation, debridement, operative stabilization of the fracture, and 1 g of cefazolin every 8 hours. At the time of admission patients were randomized to two groups. Patients in Group I received gentamicin 5 mg/kg divided into twice daily doses, and patients in Group II received gentamicin 6 mg/kg given once daily. All patients were monitored for renal toxicity and observed for radiographic and clinical signs of infection until fracture union. The results of the study revealed no statistically significant difference between once daily, high dose versus divided, low dose gentamicin in infection rates. Thus, daily dosing of gentamicin was found to be safe, effective, and cost efficient in the treatment of open fractures when combined with a cephalosporin and aggressive operative debridement and stabilization.

Adolescent↗
PubMed1992

The Ilizarov method (callus distraction) in the treatment of open fractures of the tibia.

The treatment of bone defects, in particular open fractures of the tibia, represents a significant health care concern for physicians and surgeons in the Commonwealth. Traditional methods of treatment, including those that utilize internal and/or external fixation devices, often have drawbacks. The Ilizarov method (callus distraction), which combines acute shortening with subsequent lengthening using an external ring fixator, offers a new approach to treating bone defects. The authors describe the Ilizarov method, discuss Ilizarov's research and his development of the callus distraction technique, and review the growing body of English-language literature assessing the use of the Ilizarov method.

Bone Wires↗
PubMed1987

A review of antibiotic prophylaxis for open fractures.

A review of the literature strongly supports the use of antibiotic prophylaxis in open fracture management. Because of their broad spectrum of activity, cephalosporins are the drugs of choice in cases of orthopaedic trauma. The extent of the injury determines the appropriate agent and the length of time it should be given. Patients with Type 1 or Type 2 fractures require only brief treatment (one preoperative and two postoperative doses) with an agent that has good antistaphylococci activity. Cephalothin, cefazolin, cefamandole or cefuroxime are recommended. Type 3 fractures present a much greater problem because of the risk of gram-negative infection. The marked activity of cefuroxime, cefamandole, and cefotaxime against these organisms recommends their use in such cases. Combination regimens with aminoglycosides require further study to define added efficacy and to define appropriate dosing regimens. We advocate that antibiotic prophylaxis should be given as soon as possible to all patients with open fractures and Type 3 fractures, and that prophylaxis should continue until 48 hours after adequate soft tissue coverage is achieved.

Anti-Bacterial Agents↗
PubMed2005

Planned external fixation to locked intramedullary nailing conversion for open fractures of shaft of femur and tibia.

OBJECTIVE: To determine the outcome of initial external fixation and then conversion to intramedullary nailing in patients having open fracture of shaft of femur or tibia. DESIGN: Descriptive study. PLACE AND DURATION OF STUDY: Combined Military Hospital (CMH), Quetta, from July 2002 to July 2004. SUBJECTS AND METHODS: Out of 59 patients with fractures of shaft of tibia and femur, 16 were selected for the study who had open fractures in Gustilio type I, II and III. They were initially managed with external fixators and later on converted to planned locked intramedullary nailing. Interlocking nailing was done on routine operation list in the third week after Ex Fix (external fixator) was removed. Record of patients was kept, and was statistically analyzed on SPSS. RESULTS: Out of the 16 patients, 12 had fractures of femur and 4 had fractures of tibia. Male to female ratio was 7:1. Mean duration of external fixation was 6.22 weeks. Six patients underwent closed interlocking nailing and 10 patients with open method. Fifteen fractures (94%) united within 6 months, and one fracture had delayed union. Two patients had superficial wound infection and one patient had deep infection. CONCLUSION: Immediate external fixation followed by early closed interlocking nailing is a safe and effective treatment for open fractures of shaft of femur and tibia.

Adult↗
PubMed2003

[Hyperbaric oxygenation in the treatment regimen using Ilizarov technique in patients with open fractures].

The dynamics of clinico-physiological parameters in complex treatment of patients with open fractures of the extremities using hyperbaric oxygenation was analyzed in 22 patients with severe injuries with different degree of ischemia of the extremity, and 9 patients with scanty injuries of the soft tissues. It was shown that vasospasm was observed in patients with the initially normal microcirculation after a course of HBO treatment. In patients with no or initially low capillary blood flow the microcirculation was enlarged due to vasodilatation of the arterioles. No considerable effects of the course of HBO on the main blood flow was revealed. Recommendations are given on using the HBO therapy in management of patients with severe open fractures and osteosynthesis of the injured segment by the Ilizarov methods.

Acute Disease↗
PubMed1979

The value of the Hoffmann skeletal fixation in the management of cross-leg flaps, particularly those injuries complicated by open fractures of the tibia.

The Hoffmann external fixator has been used to immobilize lower limbs for the application of cross-leg flaps in the presence of tibial fractures. The legs and the fracture are held rigidly in the optimal position during and after the operation, with ease of adjustment and excellent access to the flap. There is relatively less weight on the legs than when using a plaster cast, and with the joints free, the patient is much more mobile in bed.

Adult↗