Non-union in open tibial fractures

Re, Rosenthal; MacPhail, JA; Oritz, JE

doi:10.2106/00004623-197759020-00019

Cited by 53 publications

(10 citation statements)

References 0 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…This is in agreement with previous publications (Cox et al 1970, Edwards 1965, Mattsson 1975, Norberg 1976, Rosenthal et al 1977, Veliskakis 1959. Stable fixation is recommended for good healing of the wound as well as the fracture (Miiller et al 1979).…”

Section: Complications Of Treatmentsupporting

confidence: 94%

Antibiotic Prophylaxis in Open and Closed Fractures:A Controlled Clinical Trial

Bergman¹

1982

Acta Orthopaedica Scandinavica

View full text Add to dashboard Cite

Section: Complications Of Treatmentsupporting

confidence: 94%

Antibiotic Prophylaxis in Open and Closed Fractures:A Controlled Clinical Trial

Bergman¹

1982

Acta Orthopaedica Scandinavica

View full text Add to dashboard Cite

“…In addition, severe open tibial fractures often lead to delayed bone union, which requires further surgery such as bone grafting or bone transfer ,. and nonunion is correlated with increased infection rates . Charalambous et al in their study of 383 open tibial fractures, reported an overall infection rate of 25.6 and a 10.1% requirement for further surgery to facilitate bone union in the delayed treatment group.…”

Section: Discussionmentioning

confidence: 99%

“…When delayed reconstruction is inevitable, awareness of the best treatment option for soft tissue coverage is important to reduce complications and to achieve a successful outcome. Many articles have described various reconstructive options such as skin graft, local flap coverage, regional flap coverage, distant flap, and free flap …”

mentioning

confidence: 99%

Is delayed reconstruction using the latissimus dorsi free flap a worthy option in the management of open IIIB tibial fractures?

et al. 2015

View full text Add to dashboard Cite

Early reconstruction of severe open fractures, performed within 7 days of the injury, has a better outcome than closure after 7 days. However, the uncertain demarcation of damaged tissue often results in delayed reconstruction. In this article, we report our surgical outcomes of delayed reconstruction using latissimus dorsi free flap with internal fixation. Twenty-three patients with Gustilo type IIIB open tibial fractures Between March 2009 and May 2012 were included in this study. There were 16 cases of distal 1/3 fracture of the tibia, 4 of midshaft fracture, 1 of proximal 1/3 fracture, and 2 of segmental fracture. Serial debridement with application of negative pressure wound therapy (NPWT) was performed before the final operation. All patients underwent internal fixation of the bone and reconstruction of soft tissue defect using latissimus dorsi free flap. The number of serial debridements, excluding those performed during emergency and finial operation, ranged from 1 to 5 (mean 2.69) times. Mean time from injury to final operation was 10.65 (range, 7-22) days. All flaps survived without complications. Three cases (13%) were infected, and three cases required further bone graft surgery to facilitate bone union (13%). Bone union was achieved after a mean 6.3 (range, 3-12) months. Mean follow-up period was 16.34 (range, 12-26) months. During follow-up, all patients were able to ambulate without use of an aid. In cases of severe open fracture, treatment should emphasize soft tissue coverage rather than rushing to achieve definitive fixation in the setting of poor surrounding tissues. When delayed reconstruction is inevitable, radical debridement is performed first, then NPWT is used as bridging therapy, and free flap could be considered for definite soft tissues coverage. © 2015 Wiley Periodicals, Inc. Microsurgery 36:453-459, 2016.

show abstract

“…3 Sarmiento et al 4 stated that isolated tibia fractures healed in 17.5 weeks (range: 7-36 wk), whereas fracture of both the tibia and fibula healed in 21.5 weeks (range: 7-40 wk), and the presence of an intact fibula shortened the healing time of a tibia shaft fracture. Rosenthal et al, 5 Nicoll, 6 and Hoaglund and States 7 also identified a decreased incidence of delayed union when the fibula was intact. Nicoll 6 found that the intact fibula gave the tibia stability and minimized the amount of tibia displacement.…”

Section: Discussionmentioning

confidence: 93%