Lower limb paediatric trauma with bone and soft tissue loss: Ortho-plastic management and outcome in a major trauma centre

Messner, Juergen; Harwood, Paul; Johnson, Louise; Itte, Vinay; Bourke, Gráinne; Foster, Patrick

doi:10.1016/j.injury.2020.03.059

Cited by 22 publications

(18 citation statements)

References 34 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…A full-text assessment was then performed, which reduced the number of articles to five. Further articles were identified through searching bibliographies, resulting in seven articles eligible for inclusion in this systematic narrative synthesis [ 8 , 9 , [17] , [18] , [19] , [20] , [21] ]. With regards to quality of evidence, all of the studies which were eligible for inclusion were considered to be of moderate quality.…”

Section: Resultsmentioning

confidence: 99%

See 1 more Smart Citation

A systematic literature review and narrative synthesis on the risk factors for developing affective disorders in open lower-limb fracture patients

Abukhder

Dobbs

Shaw

et al. 2022

Annals of Medicine &Amp; Surgery

View full text Add to dashboard Cite

Section: Resultsmentioning

confidence: 99%

“…Messner et al investigated the incidence of psychological trauma in a cohort of 32 patients with open lower-limb fractures [ 19 ]. Scores for psychological assessment were only available for 21 patients at their most recent follow-up, of which 8 patients were at high risk of experiencing symptoms of PTSD [ 23 ].…”

Section: Resultsmentioning

confidence: 99%

A systematic literature review and narrative synthesis on the risk factors for developing affective disorders in open lower-limb fracture patients

Abukhder

Dobbs

Shaw

et al. 2022

Annals of Medicine &Amp; Surgery

View full text Add to dashboard Cite

“…Limb salvage and timely fracture union were possible in children with complex lower limb trauma. Early intervention with appropriate debridement, skeletal stabilization, and early soft-tissue coverage in children result satisfactory outcomes [14].…”

Section: Discussionmentioning

confidence: 99%

Profiles of Children with Lower Extremity Fracture at Saiful Anwar Malang Regional General Hospital from January 2016 to August 2020

Julana

Sananta

2022

Open Access Maced J Med Sci

View full text Add to dashboard Cite

Musculoskeletal injuries in children are a common cause of 25% of children hospitalization. Previous research stated that five pediatric fractures had significant long-term consequences such as disability and activity restriction. In Indonesia, epidemiology studies have discussed the incidence of fracture in general sites, but only a few reported lower limb fractures. The authors expect this research to be used for lower extremities fractures in children’s epidemiologic descriptions. Between January 2016 until September 2020, we included 247 children under 18 years old based on inclusion criteria. The prevalence and fractures were reviewed for detail, such as sex, age, mechanism of injury, location of the fracture, and treatment. Data were analyzed using SPSS version 26. Most common injuries occur at 13-18 years old with 164 children (66.4%). Most of them were caused by traffic accidents, 210 cases (85.0%). Consequently, femur fractures are the most common fractures due to traffic accidents 53.8% (p<0.005). From common fracture sites in this study, plating is the common to use procedure than the others (52.3%). Therefore, we can conclude that MVA were the most common injury in children, and especially for fracture femur relevant with increasing age and plating methods is common to use method for this fracture

show abstract

“…Over the past few decades, several studies have demonstrated that early soft-tissue coverage of the traumatic wound ranging from three days to 15 days decreased complications and improved reconstructive outcomes [ 11 , 12 , 13 , 14 , 15 ]. Growing evidence indicates that soft-tissue closure or coverage within 72 h of injury delivers satisfactory outcomes, indicating that multidisciplinary co-operative treatment is crucial to optimizing outcomes and that the early intervention of a collaborative orthoplastic approach is desirable for the management of open fractures [ 10 , 14 , 16 , 17 , 18 , 19 ]. Typically, based on the strength of orthopedic stable bone fixation and well vascularized coverage by plastic flaps, orthoplastic approaches lead to accelerated bone union, reliable soft-tissue coverage, shorter hospital stays, fewer complications and revision surgeries, and higher patient satisfaction [ 19 , 20 , 21 ].…”

Section: Introductionmentioning

confidence: 99%

Early Reconstruction Delivered Better Outcomes for Severe Open Fracture of Lower Extremities: A 15-Year Retrospective Study

Cao

Li²,

He³

et al. 2022

JCM

View full text Add to dashboard Cite

Background: The principle of early flap reconstruction for high-grade traumatic lower-extremity injuries established in 1986 by Godina has been widely accepted. However, the lack of an orthoplastic center in China makes early reconstruction not accessible for all patients with a Gustilo IIIB fracture. This study aimed to analyze the impact of timing on outcomes in lower-extremity traumatic free-flap reconstruction. Methods: A retrospective review identified 394 free-flap reconstructions performed from January 2005 to January 2020 for Gustilo IIIB tibial fractures. Patients were stratified based on the number of debridements: two times or less (early) and more than two times (delayed). The interval between injury and reconstruction, surgery time, hemorrhage volume, length of hospitalization (LoS), wound and bone healing time, flap outcomes, and function restoration were examined based on times of debridement. Results: The mean interval between injury and flap reconstruction in the early-repair group with 6.15 ± 1.82 postoperative days (PODs) was significantly shorter than that of the delayed-repair group with 16.46 ± 4.09 PODs (p < 0.001). The flap harvest time, reconstructive time, and intraoperative blood loss were also significantly less in the early-repair group compared to the delayed-repair group. Interestingly, we observed an 8.20% enlargement of wound size due to multiple debridements in the delayed-repair group. Most importantly, the early-repair group had better outcomes with a decreased risk of total or partial flap necrosis, lower incidence of flap complications, and fewer overall late complications than the delayed-repair group. In addition, the LoS, as well as wound and bone healing time, were notably shorter in the early-repair group. Furthermore, 4.85% of cases in the delayed-repair group experienced additional operations on bone, while no additional operations were performed in the early-repair group. All cases in both groups obtained satisfying functional results, while the early-repair group showed better functional recovery. Conclusions: Early repair with free flaps performed within two instances of debridement had superior outcomes when compared with delayed reconstruction after multiple debridements, consistent with Godina’s findings. We recommended early referral to a higher-level hospital with orthoplastic capabilities after an aggressive and thorough initial debridement carried out by senior surgeons.

show abstract

Lower limb paediatric trauma with bone and soft tissue loss: Ortho-plastic management and outcome in a major trauma centre

Cited by 22 publications

References 34 publications

A systematic literature review and narrative synthesis on the risk factors for developing affective disorders in open lower-limb fracture patients

A systematic literature review and narrative synthesis on the risk factors for developing affective disorders in open lower-limb fracture patients

Profiles of Children with Lower Extremity Fracture at Saiful Anwar Malang Regional General Hospital from January 2016 to August 2020

Early Reconstruction Delivered Better Outcomes for Severe Open Fracture of Lower Extremities: A 15-Year Retrospective Study

Contact Info

Product

Resources

About