Problems in the Management of Type III (Severe) Open Fractures

Gustilo, Ramon B.; Mendoza, Rex M.; Williams, David N.

doi:10.1097/00005373-198408000-00009

Cited by 2,110 publications

(943 citation statements)

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“…Patients with pathologic fractures (other than osteoporosis) were excluded. Operative records and charts were reviewed for patient characteristics (age, gender, smoking status, body mass index [BMI]) and fracture characteristics (laterality and soft tissue injury according to Gustilo et al [25,26]). Radiographs of the femur and knee were reviewed for fracture classification (AO/OTA [32]) and to establish the presence of a TKA.…”

Section: Methodsmentioning

confidence: 99%

Mortality After Distal Femur Fractures in Elderly Patients

Streubel

Ricci

Wong

et al. 2011

Clinical Orthopaedics &Amp; Related Research

252

163

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Background Hip fractures in the elderly are associated with high 1-year mortality rates, but whether patients with other lower extremity fractures are exposed to a similar mortality risk is not clear. Questions/purposes We evaluated the mortality of elderly patients after distal femur fractures; determined predictors for mortality; analyzed the effect of surgical delay; and compared survivorship of elderly patients with distal femur fractures with subjects in a matched hip fracture group. Patients and Methods We included 92 consecutive patients older than 60 years with low-energy supracondylar femur fractures treated between 1999 and 2009. Patient, fracture, and treatment characteristics were extracted from operative records, charts, and radiographs. Data regarding mortality were obtained from the Social Security Death Index. Results Age-adjusted Charlson Comorbidity Index and a previous TKA were independent predictors for decreased survival. Congestive heart failure, dementia, renal disease,

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Section: Methodsmentioning

confidence: 99%

Mortality After Distal Femur Fractures in Elderly Patients

Streubel

Ricci

Wong

et al. 2011

Clinical Orthopaedics &Amp; Related Research

252

163

View full text Add to dashboard Cite

show abstract

“…Profilaxia antimicrobiana foi realizada por 24 horas em todos os pacientes com cefalosporinas de primeira geração. Nos pacientes com fratura aberta, adotamos protocolo padrão de antibioticoprofilaxia, associando-se aminoglicosídeo por 48 horas nas fraturas 3A de Gustilo et al (15)(16) . Profilaxia das complicações tromboembólicas foi aplicada de lesões músculo-esqueléticas devem ser adiados até que haja adequada recuperação do trauma inicial (10,21) .…”

Section: Discussionunclassified

“…Entre os pacientes, cinco apresentaram fratura aberta do fêmur e um da pelve. As fraturas abertas do fêmur foram classificadas de acordo com Gustilo et al, sendo: uma grau 1, duas grau 2 e duas grau 3A (15)(16) . A fratura aberta da pelve foi classificada de acordo com Jones et al, sendo classe 1 (17) .…”

Section: Pacientes (N = 16)unclassified

Fraturas ipsilaterais de fêmur e pelve (quadril flutuante): análise prospectiva de 16 casos

Giordano¹,

Amaral²,

Rios³

et al. 2007

Rev. bras. ortop.

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“…The diaphyseal segment (zone 42) is the part of the tibia between the two aforementioned segments. According to the classification of open tibial fractures of Gustilo et al (1984), there were 2 type 3C fractures (1 in the proximal segment and 1 in the shaft segment) and 21 type 3B fractures (4 in the proximal segment, 10 in the shaft segment, and 7 in the distal segment).…”

Section: Methodsmentioning

confidence: 99%

Staged method using antibiotic beads and subsequent autografting for large traumatic tibial bone loss

et al. 2007

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IntroductionThe vascularity of surrounding soft tissues, which is related to muscle cover, is important for the healing of traumatic bone loss. Muscle cover on the distal tibia is limited compared to the diaphyseal and proximal tibia, and delayed healing of fractures in this area is common. We evaluated the healing of traumatic bone loss in the proximal, diaphyseal, and distal tibia.Patients and methods 23 open tibial fractures with substantial bone loss (mean 52 (34-104) mm) were treated using a staged method with antibiotic-impregnated beads and later autologous bone grafting at second-stage surgery on average 8 weeks after the injury.Results 22 fractures healed after mean 40 (20-79) weeks. The average healing time in the distal tibia (mean 30 weeks) was 7 weeks shorter (95% CI: 12-26 weeks) than in the proximal tibia (37 weeks), and 16 weeks shorter (95% CI: 3-29 weeks) than in the tibial shaft (47 weeks). The length of the bone and the type of soft tissue cover (free muscle or secondary suture) had no effect on healing time.Interpretation Our study suggests that the method we used is applicable in all parts of the tibia, although the healing of bone loss is slower in the diaphyseal tibia than in the proximal and distal tibia.

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Problems in the Management of Type III (Severe) Open Fractures

Cited by 2,110 publications

References 0 publications

Mortality After Distal Femur Fractures in Elderly Patients

Mortality After Distal Femur Fractures in Elderly Patients

Fraturas ipsilaterais de fêmur e pelve (quadril flutuante): análise prospectiva de 16 casos

Staged method using antibiotic beads and subsequent autografting for large traumatic tibial bone loss

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