Patterns and Implications of Lower Extremity Injuries in a Community Level I Trauma Center

Fairbanks, Grant; Murphy, Robert X.; Wasser, Thomas; Morrissey, W Michael

doi:10.1097/01.sap.0000125496.83395.53

Cited by 8 publications

(3 citation statements)

References 28 publications

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“…Over the last 30 years, advances in reconstructive surgery, such as the recognition and use of pediculated fasciocutaneous/muscular flaps and the introduction of microsurgery have broadened the therapeutic arsenal of the plastic surgeon in the treatment of traumatic injuries [1][2][3][4][5][6] . In addition, the lower limbs, especially the leg and foot, have some characteristics that make it difficult to treat wounds in this region, such as: thin skin coating; scarce subcutaneous tissue; terminal arterial vascularization; venous return made difficult by the orthostatic position; and of heavy loads for most of the time 7,8 .…”

Section: Introductionmentioning

confidence: 99%

Lower extremity reconstruction: epidemiology, management and outcomes of patients of the Federal District North Wing Regional Hospital

Macedo¹,

Rosa

Botelho³

et al. 2017

Rev. Col. Bras. Cir.

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Objective: to evaluate the management of lower limbs complex traumatic injuries by analyzing their characteristics, types, conduct and evolution, with emphasis on surgical treatment. Methods: we conducted a prospective study of patients treated by Plastic Surgery at a regional hospital of the Federal District during a one-year period. We collected data through serial evaluations and telephone contact records. Results: we studied 40 patients, with a mean age of 25.6 years, predominantly male (62.5%). The most frequent wounds were of the distal third of the lower limb (37.5%). Bone or tendon exposures occurred in 55% had and there was a 35% rate of exposed lower limb fractures. The treatments employed were skin grafting (57.5%), local fasciocutaneous flap (15%), muscle flap (12.5%), cross-leg fasciocutaneous flap, reverse sural flap (12.5%) and microsurgical flap (2.5%). Short-term evaluation showed that 35 patients had excellent or good results (87.5%), four had a regular result (10%), and one had an unsatisfactory result (2.5%). In the long term, of the 18 patients who answered the questionnaire, ten resumed walking, even with support, in the first three months after surgery (55.6%). Conclusion: young men involved in motorcycle accidents during leisure time represented the profile of patients with lower limb trauma requiring surgical reconstruction; the distal third of the leg was the most affected region. Grafting was the most used technique for reconstruction and postoperative functional evaluation showed that, despite complex lesions, most patients evolved with a favorable healing process and successful functional evolution.

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Section: Introductionmentioning

confidence: 99%

Lower extremity reconstruction: epidemiology, management and outcomes of patients of the Federal District North Wing Regional Hospital

Macedo¹,

Rosa

Botelho³

et al. 2017

Rev. Col. Bras. Cir.

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show abstract

“…To address this need, locoregional and social demands has led to the establishment of the largest regional Level-1 trauma center at our institution in 2006. Its cost-effectiveness and its important role in improving patients' quality of life have been reported previously [6,7]. These previous studies have focused on major mainstream departments, such as trauma surgery, orthopedic surgery, and thoracic surgery, in the trauma center [1].…”

Section: Introductionmentioning

confidence: 98%

Impact of establishing a level-1 trauma center for lower extremity trauma: a 4-year experience

et al. 2022

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Purpose A multidisciplinary approach is essential for trauma patients’ treatment, particularly for cases with open lower extremity fractures, which are considered major traumas requiring a comprehensive approach. Recently, the social demand for severe-trauma centers has increased. This study analyzed the clinical impact of establishing a trauma center for the treatment of open lower extremity fractures. Methods A retrospective chart review was conducted for trauma patients admitted to our hospital. Patients were classified into two groups: before (January 2014–December 2015, 178 patients) and after establishment of a Level-1 trauma center (January 2017–December 2018, 125 patients). We included patients with open fracture below the knee level and Gustilo type II/III, but excluded those with life-threatening trauma that affected the treatment choice. Results Total 273 patient were included in this study, initial infection was significantly more common and external fixator application significantly less in post-center establishment group. The time to emergency operation decreased significantly from 13.89 ± 17.48 to 11.65 ± 19.33 h post-center setup. By multivariate analysis, the decreased primary amputation and increased limb salvage was attributed to establishment of the trauma center. Conclusion With the establishment of the Level-1 trauma center, limbs of patients with open lower extremity fractures could be salvaged, and the need for primary amputation was decreased. Early control of initial open wound infection and minimizing external fixator use allowed early soft tissue reconstruction. The existence of the center ensured a shorter interval to emergency operation and facilitated interdepartmental cooperation, which promoted active limb salvage and contributed to patients’ quality of life.

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“…To address this need, locoregional and social demands has led to the establishment of the largest regional Level-1 trauma center at our institution in 2006. Its costeffectiveness and its important role in improving patients' quality of life have been reported previously [6,7]. These previous studies have focused on major mainstream departments, such as trauma surgery, orthopedic surgery, and thoracic surgery, in the trauma center [1].…”

Section: Introductionmentioning

confidence: 99%

Impact of Establishing A Level-1 Trauma Center For Lower Extremity Trauma: A 4-Year Experience

Kim

Yang

Hahn

et al. 2021

Preprint

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Purpose: A multidisciplinary approach is essential for trauma patients’ treatment, particularly for cases with open lower extremity fractures, which are considered major traumas requiring a comprehensive approach. Recently, the social demand for severe-trauma centers has increased. This study analyzed the clinical impact of establishing a trauma center for the treatment of open lower extremity fractures.Methods: A retrospective chart review was conducted for trauma patients admitted to our hospital. Patients were classified into two groups: before (January 2014–December 2015, 178 patients) and after establishment of a Level-1 trauma center (January 2017–December 2018, 125 patients). We included patients with open fracture below the knee level and Gustilo type II/III, but excluded those with life-threatening trauma that affected the treatment choice.Results: Total 273 patient were included in this study, initial infection was significantly more common and external fixator application significantly less in post-center establishment group. The time to emergency operation decreased significantly from 13.89 ± 17.48 to 11.65 ± 19.33 hours post-center setup. By multivariate analysis, the decreased primary amputation and increased limb salvage was attributed to establishment of the trauma center. Conclusion: With the establishment of the Level-1 trauma center, limbs of patients with open lower extremity fractures could be salvaged, and the need for primary amputation was decreased. Early control of initial open wound infection and minimizing external fixator use allowed early soft tissue reconstruction. The existence of the center ensured a shorter interval to emergency operation and facilitated interdepartmental cooperation, which promoted active limb salvage and contributed to patients’ quality of life.

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Patterns and Implications of Lower Extremity Injuries in a Community Level I Trauma Center

Cited by 8 publications

References 28 publications

Lower extremity reconstruction: epidemiology, management and outcomes of patients of the Federal District North Wing Regional Hospital

Lower extremity reconstruction: epidemiology, management and outcomes of patients of the Federal District North Wing Regional Hospital

Impact of establishing a level-1 trauma center for lower extremity trauma: a 4-year experience

Impact of Establishing A Level-1 Trauma Center For Lower Extremity Trauma: A 4-Year Experience

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