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Results for “Fractures, Open”

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PubMed1975

[Infectious complications of 227 open fractures of the leg].

Out of 557 open fractures of the leg we have analysed 472 cases in respect of recovery. We tried to discrive the relationship between the infection and the severity of the lesion and the methods of treatment resp. We have analysed also the further course of the infect.on. In our material considerable risk of the infections in the case of open leg fractures was found, since the incidence of all infections corresponded--in accordance with the data of the literature--to 16,7% of the appreciable cases. Significant relationship between the occurrence of infections and the severity of the lesion was found. In the material analysed according to the ACD code the incidence of infections is in the severely injured patients three times as much as in the case of slight or moderately severe groups. The occurrence of posttraumatic osteitis corresponds to 9,11%--this latter is similarly in relation with the severity of the lesion. The infection leads to the protraction of the osseous union,--however, no convincing data were found in the authors' material in respect of the relationship between the infection and the methods of treatment. The course and the proportion of healing of the infected cases correspond to the mean values reported in the literature. On the basis of their great material it is stated by the authors that only in the case of lesions with identical or at the least similar severity comparison of the results of recovery or of the complications is possible and suitable.

Accidents↗

PubMed1991

[Metal osteosynthesis of open fractures of the long tubular bones].

An analysis of treatment of 123 patients with open fractures of long tubular bones has shown that automobile crash is the most frequent cause of the trauma (67.5%). The prehospital aid was given only to 9.7% of the patients. The primary surgical treatment of the wounds was carried out by traditional rules, the local application of antibiotics for prophylactics of purulent complications did not justify itself. Better results of treatment of open fractures were obtained after metallo-osteosynthesis of open fractures of the femur bone. The highest percentage of complications were observed after epiosseous osteosynthesis of the leg bones.

Adolescent↗

PubMed1987

Severe open fractures of the tibia.

Sixty-two Type-III open fractures of the tibial shaft are reported on. Eleven were Type IIIA, and three of them had non-union while none were associated with deep infection or required secondary amputation. Forty-two were Type IIIB, and fifteen of them had non-union, twelve were associated with deep infection, and seven required secondary amputation. However, in the twenty-four Type-IIIB fractures that were treated with early restoration of the damaged soft tissue by local flaps or free tissue transfer, the rate of complications was significantly reduced to five non-unions, two deep infections, and two secondary amputations. Unfortunately, of the nine Type-IIIC injuries, seven ultimately required secondary amputation, from two days to sixty-three months after the initial injury, because of pain, sepsis, non-union, or failure of the vascular repair. Only two patients who had a Type-IIIC fracture have avoided amputation to date, and their results were poor.

Adolescent↗

PubMed2004

Unreamed interlocking nailing in open fractures of tibia.

PURPOSE: To assess the clinical outcome of unreamed intramedullary interlocking nailing in open fractures of tibia, and to evaluate the incidence of complications in these open fractures as a result of the unreamed intramedullary nailing. METHODS: Between June 1999 and May 2000, a total of 60 cases of open tibial shaft fractures were operated on with unreamed interlocking nails at Safdarjung Hospital, New Delhi, India. Records of 56 patients (4 women and 52 men) were available for study. Only injuries associated with the tibial shaft were included. Traffic accidents were the cause of fractures in all patients. All fractures were classified according to Gustilo and Anderson system for open fractures. There were 30 (53.6%) type-I, 18 (32.1%) type-II, 4 (7.1%) type-IIIA, and 4 (7.1%) type-IIIB fractures. After thorough debridement under anaesthesia, an unreamed interlocking nail was inserted with assistance by an image intensifier. All nails were statically locked with one screw each proximally and distally. RESULTS: The patients were followed up for a mean period of 20 months (range, 18-24 months) and were evaluated according to the modified Ketenjian's criteria. Results were good to excellent in 85.8% cases, and poor in 10.7% cases. Only 2 of 8 patients with type-III fractures had good results. Two of 4 type-IIIA and all 4 type-IIIB fractures had chronic osteomyelitis. Of 56 patients, 6 had early infection, 6 had delayed union, 6 had infected non-union, 2 had nail breakage, 8 had screw breakage, and 10 had anterior knee pain. CONCLUSION: Unreamed interlocking tibial nailing can be safely used for type-I and type-II open injuries even with delayed presentation. Use of unreamed nailing in those type-III fractures with delayed presentation was not recommended, because of high incidence of complications.

Adolescent↗

PubMed1991

Infections in open fractures of the hand.

We reviewed one forty-six consecutive cases of patients with open fractures of the hand to identify factors that predict infection and poor outcome. The incidence of infection was 11%. The infection rate in type 1 open fractures was 0%; in type 2, 9%; and in type 3, 14%. Infection occurred in 20.5% of grossly contaminated wounds (p less than 0.02), and was most common in patients with extensive soft tissue and skeletal injury. Delay in treatment did not increase the incidence of infection or affect outcome. Functional outcome was highly correlated with the initial fracture type and with the presence of infection. Preoperative wound cultures were of no value in predicting the risk of infection or the nature of the likely pathogen. Patients with severe open fractures should be warned of the risk of infection, prolonged convalescence, and permanent impairment.

Adolescent↗

PubMed1976

Prevention of infection in the treatment of one thousand and twenty-five open fractures of long bones: retrospective and prospective analyses.

In 673 open fractures of long bones (tibia and fibula, femur, radius and ulna, and humerus) treated from 1955 to 1968 at Hennepin County Medical Center, Minneapolis, Minnesota, and analyzed retrospectively, the infection rate was 12 per cent from 1955 to 1960 and 5 per cent from 1961 to 1968. In a prospective study from 1969 to 1973, 352 patients were managed as follows: débridement and copious irrigation, primary closure for Type I and II fractures and secondary closure for Type III fractures, no primary internal fixation except in the presence of associated vascular injuries, cultures of all wounds, and oxacillin-ampicillin before surgery and for three days postoperatively. In 158 of the patients in the prospective study the initial wound cultures revealed bacterial growth in 70.3 per cent and the infection rate was 2.5 per cent. Sensitivity studies suggested that cephalosporin is currently the prophylactic antibiotic of choice. For the Type III open fractures (severe soft-tissue injury, segmental fracture, or traumatic amputation), the infection rates were 44 per cent in the retrospective study and 9 per cent in the prospective study.

Arteries↗

PubMed1955