Open Type IIIB and IIIC Fractures Treated by an Orthopaedic Microsurgical Team

Pn, Soucacos; Ae, Beris; Ta, Xenakis; Kn, Malizos; Vekris,

doi:10.1097/00003086-199505000-00009

Cited by 6 publications

(5 citation statements)

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“…A selection of studies, including some historical papers, reporting on outcomes in terms of amputation or salvage with grade IIIC fractures are shown in Table III. 1,2,9,16,25,[33][34][35][36][37] Most of the studies have combined data on IIIB and IIIC fractures; we have only included IIIC fractures from those studies.…”

Section: Discussionmentioning

confidence: 99%

Gustilo IIIC fractures in the lower limb

Soni

Tzafetta

Knight

et al. 2012

The Journal of Bone and Joint Surgery. British volume

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Controversy continues to surround the management of patients with an open fracture of the lower limb and an associated vascular injury (Gustilo type IIIC). This study reports our 15-year experience with these fractures and their outcome in 18 patients (15 male and three female). Their mean age was 30.7 years (8 to 54) and mean Mangled Extremity Severity Score (MESS) at presentation was 6.9 (3 to 10). A total of 15 lower limbs were salvaged and three underwent amputation (two immediate and one delayed). Four patients underwent stabilisation of the fracture by external fixation and 12 with an internal device. A total of 11 patients had damage to multiple arteries and eight had a vein graft. Wound cover was achieved with a pedicled flap in three and a free flap in six. Seven patients developed a wound infection and four developed nonunion requiring further surgery. At a mean follow-up of five years (4.1 to 6.6) the mean visual analogue scale for pain was 64 (10 to 90). Depression and anxiety were common. Activities were limited mainly because of pain, and the MESS was a valid predictor of the functional outcome. Distal tibial fractures had an increased rate of nonunion when associated with posterior tibial artery damage, and seven patients (39%) were not able to return to their previous occupation.

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Section: Discussionmentioning

confidence: 99%

Gustilo IIIC fractures in the lower limb

Soni

Tzafetta

Knight

et al. 2012

The Journal of Bone and Joint Surgery. British volume

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“…The application of microsurgical techniques has been responsible for significant success in terms of extremity salvage and secondary reconstruction [ 5 , 6 , 9 ]. However, an attempt for limb salvage should not be made on the basis of what is technically possible [ 10 ].…”

Section: Discussionmentioning

confidence: 99%

“…Several factors require consideration, such as the extent and severity of vascular injury, bone and soft tissue destruction, the type and duration of limb ischemia, patient's age and previous health status, and the presence of concomitant organ injuries. Efforts should be directed not just to salvage a limb, but to produce a functional painless extremity with at least protective sensation [ 5 , 6 ].…”

Section: Introductionmentioning

confidence: 99%

The mangled extremity and attempt for limb salvage

et al. 2009

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“…These injuries represent a major challenge to the orthopaedic surgeon. Furthermore, aggressive soft tissue management with skeletal stabilization and management of neurovascular injury are necessary for successful outcome [4]. On the other hand, it is clear that the treatment should be individualized.…”

Section: Introductionmentioning

confidence: 99%