A Sequential Protocol for Management of Severe Open Tibial Fractures

Cole, James; Ansel, L. J.; Schwartzberg, Randy

doi:10.1097/00003086-199506000-00010

Cited by 36 publications

(42 citation statements)

References 0 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…[1] The exposed anatomical location of the tibia makes it vulnerable to the direct blow and high energy trauma as a result of motor vehicle accidents, thus resulting in comminuted fractures which are frequently open with significant loss of skin and soft tissues. [2] Because of the high prevalence of complications associated with these fractures, management often is difficult and the optimum method of treatment remains a subject of controversy. [3] Among the various modalities of treatment such as conservative gentle manipulation and use of short leg or long leg cast, open reduction and internal fixation with plates and screws, intramedullary fixation (Including Ender Pins, intramedullary nails and interlocking intramedullary nails with reaming (or) without Reaming) and External fixation techniques, surgeon should be capable of using all these techniques and must weigh advantages and disadvantages of each one and adapt the best possible treatment.…”

Section: Introductionmentioning

confidence: 99%

“…[3] Among the various modalities of treatment such as conservative gentle manipulation and use of short leg or long leg cast, open reduction and internal fixation with plates and screws, intramedullary fixation (Including Ender Pins, intramedullary nails and interlocking intramedullary nails with reaming (or) without Reaming) and External fixation techniques, surgeon should be capable of using all these techniques and must weigh advantages and disadvantages of each one and adapt the best possible treatment. [1,2,3,4] The best treatment is determined by a thoughtful analysis of morphology of the fracture, the amount of energy imparted to the extremity, the mechanical characteristics of the bone, the age and general conditions of the patient and most importantly the status of the soft tissues (The skin, muscle associated neurologic and vascular structure of the leg).…”

Section: Introductionmentioning

confidence: 99%

“…Apart from it bulky frames and frequent pin tract infections make it an unfavourable choice of implant. [2] J. Evolution Med. Dent.…”

Section: Introductionmentioning

confidence: 99%

“…They are, however, contraindicated for comminuted fractures, as there tends to be shortening or displacement of such fractures around these small nails. [2] The locking of intramedullary nails to the major proximal and distal fragments decreases the prevalence of malunion of comminuted fractures. Until recently, however, all interlocking intramedullary nailing involved reaming, which destroys the endosteal blood supply.…”

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Management of Diaphyseal Fractures of Tibia in Adults Treated Either With Cast or Intramedullary Nailing With Special Reference to Enders Nail

G¹,

Nekkanti²,

Adarsh³

et al. 2016

jemds

View full text Add to dashboard Cite

Fractures of the tibial shaft are important for the reason that they are common and controversial. The exposed anatomical location of the tibia makes it vulnerable to the direct blow and high energy trauma as a result of motor vehicle accidents, thus resulting in comminuted fractures, which are frequently open with significant loss of skin and soft tissues. Because of the high prevalence of complications associated with these fractures, management often is difficult and the optimum method of treatment remains a subject of controversy. MATERIALS AND METHODSWe aim to study all the cases with diaphyseal fractures of tibia in adults. We also wanted to study clinically and radiologically the incidence, causes, types and various types of management of diaphyseal fractures of tibia with special emphasis on Ender nailing. Finally, we compared our results of cases managed by different treatment methods. CONCLUSIONOut of the various treatment modalities, in our experience surgical management of diaphyseal tibia fractures has better functional outcomes compared to conservative management. The incidence of complications like knee and ankle stiffness and malunion are much lesser in surgical management compared to the patients managed conservatively. Out of the two surgical methods, patients operated with IMIL nails had better function and lesser complications.

show abstract

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

“…Apart from it bulky frames and frequent pin tract infections make it an unfavourable choice of implant. [2] J. Evolution Med. Dent.…”

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Management of Diaphyseal Fractures of Tibia in Adults Treated Either With Cast or Intramedullary Nailing With Special Reference to Enders Nail

G¹,

Nekkanti²,

Adarsh³

et al. 2016

jemds

View full text Add to dashboard Cite

show abstract

“…4 Interlocking intramedullary nailing of tibia greatly improve rotational stability. 5,6 The fracture below the level of the tibial tubercle and above the plafond can be treated with unreamed intramedullary stabilisation regardless of the severity of soft tissues. The small size of unreamed tibial nail is associated with increased rate of nail or screws breakage.…”

mentioning

confidence: 99%

Functional Outcome of Interlocking Nailing of Type I and Ii Compound Fracture Tibia

Baby¹,

Kunjappan²

2018

jemds

View full text Add to dashboard Cite

BACKGROUND Introduction of closed locked intramedullary nailing has revolutionised the management of fractures of femur and tibia. The study is to prove type-I and type-II open fractures with comparatively less soft tissue damage and contamination, can be safely managed by debridement, early wound care and an unreamed/ reamed interlocking nailing without any deep infection hence allowing early mobilisation, reducing morbidity, reducing reoperation/ secondary procedures and malunion/ non-union. MATERIALS AND METHODSA prospective observational study was approved by the Hospital Ethical Committee and an informed consent was taken from all patients. 30 patients who underwent IL nailing from March 2011 to 2012 were enrolled in this study. Of the 30 patients, 17(56.7%) patients had fracture in right tibia and 13(43.3%) had fracture in left tibia. Age of the patients ranged from 18 to 65 years with mean age being 35.5. Males dominated (73.3%) in this study population and the sex ratio was found to be 2.75. Females were represented by only 26.7%. RESULTSIn this study all the cases united irrespective of the Gustilo and Anderson (G and A), OTA classification, Level of fracture and Mode of injury. Time of union ranges between 15 to 24 weeks with mean time of union is 20.1. Shortest time for a union was within 15 weeks (1 case) which was grade I Gustilo and Anderson, middle 3 rd , transverse, OTA-A fracture and maximum time taken was a period of 24 weeks (2 cases) which were type II, lower3 rd fractures. From this, it is observed that there is a difference in union rate between Level, Gustilo and Anderson, and OTA classifications. In this study, it is observed that there were no cases of deep infection. CONCLUSIONClosed interlocking intramedullary nailing is an effective method of treatment for Gustilo and Anderson type I and II compound tibial diaphyseal fractures. It is based on the principle of promoting biological healing and allows gradual weight bearing. Closed nailing and static locking is a technically demanding procedure. Risk of exposure to radiation is there. This method offers the possibility of maintenance of length, alignment and rotational stability in fractures of the tibial shaft, while preserving the biological environment of fracture healing. The fixation is rigid, hence there is no need for external immobilisation prior to callus formation and weight bearing. KEYWORDSCompound Fracture Tibia, Gustilo and Anderson (G and A) Classification, Interlocking Intramedullary Nailing. HOW TO CITE THIS ARTICLE: Baby S, Kunjappan MM. Functional outcome of interlocking nailing of type I and II compound fracture tibia.

show abstract

Defect Fracture of the Distal Fibula with Soft Tissue Damage (Gustilo IIIB) in an Adolescent

Lattig¹,

Remiger²,

Blatter³

et al. 2002

European Journal of Trauma

View full text Add to dashboard Cite

Open fractures of the lower limb are often combined with soft tissue defects and require a musculocutaneous flap in addition to bony reconstruction. We report the treatment and progress of a third-degree open fracture of the lower limb with a defect of the distal fibula and a Salter III fracture of the medial malleolus in a 15-year-old patient. The defect was reconstructed with a rib-latissimus dorsi flap and stabilized with a new type of internal fixator (PointContact Fixator®, Synthes Ltd).

show abstract

A Sequential Protocol for Management of Severe Open Tibial Fractures

Cited by 36 publications

References 0 publications

Management of Diaphyseal Fractures of Tibia in Adults Treated Either With Cast or Intramedullary Nailing With Special Reference to Enders Nail

Management of Diaphyseal Fractures of Tibia in Adults Treated Either With Cast or Intramedullary Nailing With Special Reference to Enders Nail

Functional Outcome of Interlocking Nailing of Type I and Ii Compound Fracture Tibia

Defect Fracture of the Distal Fibula with Soft Tissue Damage (Gustilo IIIB) in an Adolescent

Contact Info

Product

Resources

About