Management of open fractures: A narrative review

Dheenadhayalan, Jayaramaraju; Nagashree, Vasudeva; Devendra, Agraharam; Velmurugesan, Purnaganapathi Sundaram; Rajasekaran, Shanmuganathan

doi:10.1016/j.jcot.2023.102246

Cited by 1 publication

(1 citation statement)

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“…Properly applied internal fixation can promote better healing and functional recovery in such situations. Excluding cases of heavy organic contamination, definitive fixation of fractures can be conducted in the upper, but not the lower, extremities 5 , 6 . Meanwhile, antibiotic cement-coated implants have been used in the treatment of osteomyelitis and have shown promising results 7 , 8 .…”

Section: Introductionmentioning

confidence: 99%

A novel primary antibiotic cement-coated locking plate as a temporary fixation for the treatment of open tibial fracture

Kang,

Wu,

et al. 2023

Sci Rep

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Complex lower extremity trauma reconstruction remains a challenge. This study used an internal fixation composite structure of antibiotic cement plates as a temporary fixation to treat lower extremity Grade III open fractures; thus, reducing the treatment period and complications of external fixation. We aimed to assess the safety and efficacy of this technique in the initial surgery stage. Between January 2018 and March 2021, 20 patients with Gustilo grade IIIB/C open fractures received an antibiotic cement-coated locking plate as a temporary internal fixator during initial surgery. Thorough debridement and temporary internal fixation were performed with a 3.5-mm system antibiotic cement-coated locking plate. Ten patients required free bone fragment removal, followed by bone cement packing. The final stage involved internal fixation and wound repair with a free anterolateral thigh flap. Clinical and imaging results were retrospectively analysed. The repair time ranged 1–7 days. All flaps survived. Two patients experienced wound infection, and one developed severe bone infection 3 months after three-stage bone graft surgery. Autologous cancellous bone grafting was performed on 10 patients with bone defects 6 weeks after surgery. Bone union was universally achieved after 1 year. This method proved safe and effective, successfully repairing Grade III open fractures of the lower extremity 1–7 days post-treatment.

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