Are bilateral tibial shaft fractures associated with an increased risk for adverse outcome?

Lichte, Philipp; Weber, Christian David; Sellei, Richard Martin; Hildebrand, Frank; Lefering, Rolf; Pape, Hans-Christian; Kobbe, Philipp

doi:10.1016/j.injury.2014.10.005

Cited by 13 publications

(7 citation statements)

References 34 publications

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“…Simultaneous bilateral femoral shaft fractures mortality has shown to be as high as 16% in a study by [13], surprisingly we encountered no mortality. The authors believe that due of initial adequate resuscitation and management no mortality was reported, and our patients had minimum morbidity.…”

Section: Open N=5contrasting

confidence: 45%

Management of Simultaneous Bilateral Femur Fractures in a Tertiary Care Hospital: A Retrospective Review

Naqvi¹,

Askari²,

Ahsraf³

2017

Natl. j. health sci.

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Introduction: Bilateral long bone fractures are rare and usually are associated with increased risk of complications. These fractures are usually associated with poly traumatic injuries or high impact trauma resulting in shock. Commonest etiology is road traffic accident. Closed diaphyseal fractures are best managed by intramedullary nailing; management becomes difficult if there are open fractures and late arrival. In this study we intend to present our experience of managing these patients. Materials and Methods:Medical records of all adult patients (age more than 16 years of age) admitted at Aga Khan University and Hospital with bilateral femur fractures +/-other systemic injuries 2006-2014 were reviewed retrospectively. Adult patients with complete medical records were included and patients with missing data were excluded from the study. SPSS version 19 was used for data entering and Statistical analysis. Results:We retrieved 11 cases of bilateral femur fractures. Mean age of patients was 34.5 +/-20.9, with male predominance constituting 72.7%. Common mode of injury was fall from height and road traffic accident (RTA) 45.5% each, with the exception of one gunshot. Mean Injury Severity Score was 26.9+/-7.79. Mean Revised Trauma Score was 7.39 +/-0.62; mean Trauma Injury and Severity Score was 92.4 +/-6.6%. 2 patients had surgical site infections and 1 had non-union. We encountered no mortality. Increase ISS is associated with increased risk of morbidity and length of hospital stay (p= 0.02).

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Section: Open N=5contrasting

confidence: 45%

Management of Simultaneous Bilateral Femur Fractures in a Tertiary Care Hospital: A Retrospective Review

Naqvi¹,

Askari²,

Ahsraf³

2017

Natl. j. health sci.

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“…According to the literature, in this category of patients sepsis is diagnosed from 14.6 % to 21.6 % of cases [3,5,11], MOF from 12,0 % to 40,2 % [3,5,11].…”

Section: Discussionmentioning

confidence: 98%

“…Polytrauma is an important social problem as it is characterized by high morbidity and mortality rates. According to the literature, mortality ranges from 16.9 % to 35.5 % among patients with polytrauma and multiple long bone fractures of lower extremities [3,5,8,11].…”

Section: Discussionmentioning

confidence: 99%

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Does the Term of Definitive Osteosynthesis of Multiple Long Bone Fractures of Lower Extremities Impact on Treatment Outcomes in Polytrauma Patients

Burianov

Дубров

Omelchenko

et al. 2020

EUREKA: Health Sciences

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The aim: to determine the timing impact of definitive multiple long bone fracture osteosynthesis of lower extremities on complications development, duration of Mechanical Ventilation (MV), Length of Stay in Intensive Care Unit (LOS-ICU), Hospital length of Stay (H-LOS) in patients with polytrauma treated according to Damage Control Orthopedics (DCO). Materials and methods: a prospective controlled non-randomized trial in parallel groups conducted in polytrauma department of Kyiv City Clinical Hospital No. 17 from February 2016 to January 2020, which included 107 adult patients with polytrauma, multiple long bone fractures of lower extremities, one of which femur treated according to DCO. The patients were divided into two groups: Group I included 51 patients who underwent definitive osteosynthesis of long bone fractures of lower extremities after patient condition stabilization ≥24 hours ≤5 days; Group II included 56 patients who underwent definitive osteosynthesis of long bone fractures of lower extremities during the period >5 days after injury. Results: there were no statistically significant differences between Group I and Group II patients in demographics, injury mechanism, trauma severity and general patient condition. Group I patients who underwent osteosynthesis from 2nd to 5th days after injury had lower pneumonia incidence, compared to Group II patients (17.6 % vs. 26.8 %, p=0.047), shorter MV duration (9.3±6.9 vs. 14.9±9.1, p=0.048), ICU-LOS (13.5±8.3 vs. 19.1±11.0, p=0.037), and H-LOS (30.3±13.9 vs. 38.9±15.5, p=0.046). Conclusion: performing definitive multiple fracture osteosynthesis of lower extremity long bones after polytrauma patient stabilization from 2nd to 5th days after injury allowed to reduce the frequency of pneumonia, shorten the duration of MV, LOS-ICU and H-LOS, compared with its implementation after 5th days

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“…[9] Early stabilization mandatory however, the de nitive treatment still required but further evidence still needs to be looked upon before a de nitive opinion can be established. [10] Bilateral femoral shaft fractures the percentage of mortality reach to 16% in a study by, [11] we treated these patients as early as possible without any death rate in these group patients, also with less morbidity rate. The suitable xation with early stabilization of the isolated fractures femur improved the hemodynamic stability later on.…”

Section: Introductionmentioning

confidence: 98%

Hemodynamic Instability of the Closed Fractures Femur in Children

Alkhuzai

2021

Preprint

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Background: This is a prospective Study to assess the occurrence of hypovolemic shock in children with traumatic isolated closed fractures femur. This is common in children and adolescent as result of trivial to high energy trauma. Methods: A prospective descriptive study was performed on children with traumatic femoral fractures from the 20th of September 2015 to the 15th August 2018. Selection of 100 patients presented with isolated closed fracture femur in children, were admitted to the Sul. Emergency Hospital. Reason was to correct the old criteria of blood transfusion immediately, without suitable indication of replacement with real blood requirements. Depend on the children clinical parameters rather than on hemoglobin or hematocrit concentration; pulse rate. Systolic blood pressure, respiratory rate, Skin capillary refill time, and the mental status. Excluded open fractures and bilateral fracture femur in children, also excluded any fracture associated with trauma to the body organ as associated injury. Results: There was no evidence of hemodynamic instability in the 100 patients of these type fractures, selection inclusion criteria of the study when compared with internationally accepted normal vital sign parameters. No any patients in the study had hemoglobin less than 8.5 g/dl, the vital sign between these groups were similar, 2-6% incidence with hemodynamic instability has found among multiple injured children with femoral fractures, has excluded from the study. Conclusions: No evidence of hemodynamic instability was found in children with traumatic isolated femoral fractures bone. The Hemoglobin and hematocrit ratios early were non dependable, later on not significantly decreased or change to abnormal rate. Depending on vital signs parameters in the femur bone fractures patients after exclusion of bilateral fractures femur, and associated injury or patients with compound fractures, we confirmed that isolated closed femoral fractures are hemodynamically stable.

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Are bilateral tibial shaft fractures associated with an increased risk for adverse outcome?

Cited by 13 publications

References 34 publications

Management of Simultaneous Bilateral Femur Fractures in a Tertiary Care Hospital: A Retrospective Review

Management of Simultaneous Bilateral Femur Fractures in a Tertiary Care Hospital: A Retrospective Review

Does the Term of Definitive Osteosynthesis of Multiple Long Bone Fractures of Lower Extremities Impact on Treatment Outcomes in Polytrauma Patients

Hemodynamic Instability of the Closed Fractures Femur in Children

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