ArticleWorld journal of orthopedics2021
Strategies and outcomes in severe open tibial shaft fractures at a major trauma center: A large retrospective case-series.
Article in World journal of orthopedics, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.
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Who cites it
4 citing papers in PubMed.
- Circular frame versus reamed intramedullary tibial nail in the treatment of grade III open tibial diaphyseal fractures.European journal of orthopaedic surgery & traumatology : orthopedie traumatologie · 2024Article
- The Clinical Application of Double Taylor Spatial Frame in Segmental Tibial Fracture.Orthopaedic surgery · 2024Article
- Accuracy of correction of a hexapod frame, patient-specific osteotomy and reduction guides, and hinged circular external fixation in a 3D-printed canine antebrachial deformity model.Frontiers in veterinary science · 2024Article
- Higher Modified Frailty Index Score is Associated with Increased 30-Day Postoperative Complications Following Surgical Treatment of Tibial Shaft Fractures.The archives of bone and joint surgery · 2024Article
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3 authors.
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Abstract
backgroundSevere open tibia fractures are challenging to treat with a lack of published clear management strategies. Our aim was to provide an overview of the largest single-center experience in the literature, with minimum 1-year follow-up, of adult type 3 open tibial shaft fractures at Cambridge University Hospitals (a United Kingdom major trauma center). We sought to define patient characteristics and our main outcome measures were infection, union and re-fracture.
aimTo retrospectively define patient and injury characteristics, present our surgical methods and analyze our outcomes-namely infection, union and re-fracture rates.
methodsConsecutive series of 74 patients with 75 open tibial fractures treated between 2014 and 2020 (26 classified as Gustilo-Anderson 3A, 47 were 3B and two were 3C). Nine patients underwent intramedullary nailing (IMN), 61 underwent Taylor spatial frame (TSF) fixation and 5 were treated with Masquelet technique (IMN and subsequent bone grafting).
resultsMean follow-up was 16 mo (IMN) and 25 mo (TSF). We had an infection rate of 6.7% (5), non-union rate of 4% (3) and re-fracture rate of 2.7% (2). Average time to union was 22 wk for IMN and 38.6 wk for TSF. Thirty-three cases had a bone defect with a mean of 5.4 cm (2-11). Patient age, sex, diabetes, smoking status or injury severity did not have a significant effect on union time with either fixation method. Our limb salvage rate was 98.7%.
conclusionGrade 1 to 3A injuries can effectively be treated with reamed or unreamed IMN. Grade 3B/C injuries are best treated by circular external fixators as they provide good, reproducible outcomes and allow large bone defects to be addressed
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