The classification of open fractures: Are we there yet?

Roberts, Craig S.; Adams, Erin L.

doi:10.1016/j.injury.2012.12.016

Cited by 11 publications

(15 citation statements)

References 22 publications

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“…Type III open fractures proved the most difficult to classify and treat owing to the varied injury patterns, increased morbidity from associated injuries, massive soft tissue damage or loss over the fracture sites, compromised vascularity, wound contamination, and fracture instability [13]. Infection in Type III open fractures was observed in up to 50% of cases [14]. It became evident that the variation in severity, etiology, and prognosis of Type III injuries made a single classification too non-specific [14].…”

Section: Classificationmentioning

confidence: 99%

“…Infection in Type III open fractures was observed in up to 50% of cases [14]. It became evident that the variation in severity, etiology, and prognosis of Type III injuries made a single classification too non-specific [14]. The relatively high frequency of these injuries made the issue even more pressing.…”

Section: Classificationmentioning

confidence: 99%

“…Despite its familiarity and common use in the orthoplaedic community, the Gustilo-Anderson classification has left many questions unanswered [14]. There is often inter-observer disagreement between different surgeons as to which grade is appropriate for a given injury and often intra-observer differences when shown the same injury at different times [14]. The Gustilo-Anderson classification has undergone unofficial modification in common usage over time creating more variability in the assessment.…”

Section: Classificationmentioning

confidence: 99%

“…An important category of the Gustilo-Anderson classification (3B) is determined by how the soft tissue wound is treated (the need for flap coverage signifies a 3B category), which is problematic since indications for flap coverage have changed over the last 30 years and vary between clinicians. [14] The introduction of wound vacuum technology has dramatically reduced the frequency of free flap procedures in many situations [14]. Horn and Rettig, and then Brumback and Jones, raised many questions about the lack of reliability of the Gustilo-Anderson classification [14].…”

Section: Classificationmentioning

confidence: 99%

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2017

MOJOR

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Throughout history, there has been a fear of open tibial fractures due to the high incidence of infection potentially leading to amputation and death. Before the development of standardized surgical wound treatment and antisepsis, amputations were frequently required to prevent spread of sepsis and risk of death. Even today, this remains a challenging condition to treat. In recent years efforts have been made to develop new techniques and to promote new evidence based guidelines for the management of these injuries. The cooperation between orthopaedic and plastic surgeons together with the use of modern surgical instruments and techniques and modern wound management has resulted in a dramatic reduction in infection rates in many parts of the developed and developing world.

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Section: Classificationmentioning

confidence: 99%

Section: Classificationmentioning

confidence: 99%

Section: Classificationmentioning

confidence: 99%

Section: Classificationmentioning

confidence: 99%

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2017

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“…In a recent article, Corona et al concluded that muscle trauma involving volumetric muscle loss (VML) contributes to >90% of muscle conditions that result in long‐term disability in patients who have been medically retired because of injury . Muscle damage or impaired muscle function is often a secondary complication associated with a broad range of injuries commonly sustained in military conflicts including peripheral nerve injury, tenotomy, ischemia–reperfusion injury, and open fractures . Currently, there are no approved regenerative therapies for the treatment of muscle tissue following VML, presenting a significant opportunity to produce tissue engineered scaffolds for muscle tissue regeneration.…”

Section: Introductionmentioning

confidence: 99%

Biomimetic sponges for regeneration of skeletal muscle following trauma

Haas

Dunn

Marcinczyk

et al. 2018

J Biomedical Materials Res

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Skeletal muscle is inept in regenerating after traumatic injuries due to significant loss of basal lamina and the resident satellite cells. To improve regeneration of skeletal muscle, we have developed biomimetic sponges composed of collagen, gelatin, and laminin (LM)-111 that were crosslinked with 1-ethyl-3-(3-dimethyl aminopropyl) carbodiimide (EDC). Collagen and LM-111 are crucial components of the muscle extracellular matrix and were chosen to impart bioactivity whereas gelatin and EDC were used to provide mechanical strength to the scaffold. Morphological and mechanical evaluation of the sponges showed porous structure, water-retention capacity and a compressive modulus of 590-808 kPa. The biomimetic sponges supported the infiltration and viability of C 2 C 12 myoblasts over 5 days of culture. The myoblasts produced higher levels of myokines such as VEGF, IL-6, and IGF-1 and showed higher expression of myogenic markers such as MyoD and myogenin on the biomimetic sponges. Biomimetic sponges implanted in a mouse model of volumetric muscle loss (VML) supported satellite, endothelial, and inflammatory cell infiltration but resulted in limited myofiber regeneration at 2 weeks post-injury.

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Ocular Sonography

2015

Encyclopedia of Trauma Care

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Self-care instructor DefinitionA specialist who teaches individuals with physical impairments compensatory techniques to accomplish self-care tasks.The occupational therapist teaches compensatory techniques to increase the rehab patient's self-care or activities of daily living (ADLs). These classically include toileting, bathing, grooming, dressing, and feeding. Instrumental activities of daily living (IADLs) include housekeeping, money management, shopping, transportation, and food preparation. IADLs are not essential for daily functioning, but they let an individual live independently in the community. A trauma patient with pelvic fracture and abdominal visceral injury s/p exploratory laparotomy may have weight-bearing restrictions and abdominal pain. The patient will work with OT on techniques for shifting side to side to pull on

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The classification of open fractures: Are we there yet?

Cited by 11 publications

References 22 publications

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Biomimetic sponges for regeneration of skeletal muscle following trauma

Ocular Sonography

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