Noncontiguous and open fractures of the lower extremity: Epidemiology, complications, and unplanned procedures

Chen, Andrew T.; Vallier, Heather A.

doi:10.1016/j.injury.2015.12.013

Cited by 33 publications

(23 citation statements)

References 21 publications

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“…Additionally, rehospitalizations are relatively common, suggesting that failure to heal is still a significant problem. Lower extremity injuries, specifically, are also associated with high rates of delayed amputation and hospitalization …”

Section: Current Burden and Treatment Of Extremity Traumamentioning

confidence: 99%

Inhibition of fracture healing in the presence of contamination byStaphylococcus aureus: Effects of growth state and immune response

et al. 2017

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Extremity injuries comprise a significant portion of trauma, affecting quality of life, financial burden, and return to duty. Bacterial contamination is commonly associated with failure to heal, despite antibiotic treatment, suggesting that additional therapies must be developed to combat these complications. Treatment failure is likely due to the presence of resistant microbial communities known as biofilms. Biofilm bacteria are able to elicit a direct inhibition of healing through a multitude of known factors. However, they likely also inhibit healing through alteration of the inflammatory response. As inflammation is a critical step in fracture healing, how the presence of biofilm bacteria shifts this response to one that is suboptimal for healing is an important consideration that is currently understudied. The profile of inflammatory factors in response to biofilm bacteria is unique and distinct from those induced during normal healing or by planktonic bacteria alone. This review will examine the presence of inflammatory factors during normal healing and those induced by contaminating bacteria, and will discuss how these differences may ultimately lead to nonunion. Specifically, this review will focus on the Th1/Th2/Th17 type inflammatory responses and how shifts in the balance of these responses during infection can lead to both ineffective clearance and disruption of fracture healing. © 2017 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 35:1845-1854, 2017.

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Section: Current Burden and Treatment Of Extremity Traumamentioning

confidence: 99%

Inhibition of fracture healing in the presence of contamination byStaphylococcus aureus: Effects of growth state and immune response

et al. 2017

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“…Closed and Gustilo type-I open fractures have lowest rate of infection (1.8%), while severe high energy lower extremity open fractures have highest occurrence of infection (27%), with the tibia being the most commonly affected. [11][12][13][14][15] The overall incidence of bone infection may continue to rise due to multiple factors including improved diagnosis, increasing patient risk factors (i.e. diabetes), and increased needs for arthroplasties.…”

Section: Introductionmentioning

confidence: 99%

Osteomyelitis: Recent advances in pathophysiology and therapeutic strategies

Birt

Anderson

Toby

et al. 2017

Journal of Orthopaedics

176

127

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This review article summarizes the recent advances in pathogenic mechanisms and novel therapeutic strategies for osteomyelitis, covering both periprosthetic joint infections and fracture-associated bone infections. A better understanding of the pathophysiology including the mechanisms for biofilm formation has led to new therapeutic strategies for this devastating disease. Research on novel local delivery materials with appropriate mechanical properties, lower exothermicity, controlled release of antibiotics, and absorbable scaffolding for bone regeneration is progressing rapidly. Emerging strategies for prevention, early diagnosis of low-grade infections, and innovative treatments of osteomyelitis such as biofilm disruptors and immunotherapy are highlighted in this review.

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“…The prime objectives of treatment of open fractures of distal tibia are the prevention of infection, promotion of soft tissue healing, stabilization of fracture and restoration of function of affected extremity. 9,10,11,12 A good surgical debridement is of paramount importance in eliminating the chances of infection. Primary internal fixation is preferred wherever possible in preventing malunion and early mobilization and return to activities.…”

Section: Discussionmentioning

confidence: 99%

Analysis of Supracutaneous Locking Compression Plate in Compound Distal Metaphyseal Fractures of Tibia- A Prospective Study

K.V¹,

Soraganvi²,

C³

et al. 2019

jemds

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BACKGROUND Complexity of open tibial fractures is on the rise with increased high-velocity road accidents. Temporary bony stabilization by external fixation avoids the instability at the fracture site and promotes healing of soft tissues. There is paucity of literature ascertaining the role of Locking Compression Plate (LCP) as external fixator device in compound tibial fractures. Hence a study was undertaken to assess the role of LCP as an external fixation tool in providing stability to the fractured bone. MATERIALS & METHODS A prospective study was done on 21 consenting patients with open distal metaphyseal fractures of the tibia. Demographic, clinical and radiological assessment was done. Lower Extremity Functional Scale (LEFS) was used as an outcome measure. RESULTS There was a 90% union rate in patients treated with LCP. There was an identifiable improvement in LEFS after treatment. CONCLUSION LCP as an external fixation device is an effective and safe method with good union rate.

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Noncontiguous and open fractures of the lower extremity: Epidemiology, complications, and unplanned procedures

Cited by 33 publications

References 21 publications

Inhibition of fracture healing in the presence of contamination byStaphylococcus aureus: Effects of growth state and immune response

Inhibition of fracture healing in the presence of contamination byStaphylococcus aureus: Effects of growth state and immune response

Osteomyelitis: Recent advances in pathophysiology and therapeutic strategies

Analysis of Supracutaneous Locking Compression Plate in Compound Distal Metaphyseal Fractures of Tibia- A Prospective Study

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