Document Detail


Gustilo IIIC fractures in the lower limb: Our 15-year experience.
MedLine Citation:
PMID:  22529094     Owner:  NLM     Status:  In-Data-Review    
Abstract/OtherAbstract:
Controversy continues to surround the management of patients with an open fracture of the lower limb and an associated vascular injury (Gustilo type IIIC). This study reports our 15-year experience with these fractures and their outcome in 18 patients (15 male and three female). Their mean age was 30.7 years (8 to 54) and mean Mangled Extremity Severity Score (MESS) at presentation was 6.9 (3 to 10). A total of 15 lower limbs were salvaged and three underwent amputation (two immediate and one delayed). Four patients underwent stabilisation of the fracture by external fixation and 12 with an internal device. A total of 11 patients had damage to multiple arteries and eight had a vein graft. Wound cover was achieved with a pedicled flap in three and a free flap in six. Seven patients developed a wound infection and four developed nonunion requiring further surgery. At a mean follow-up of five years (4.1 to 6.6) the mean visual analogue scale for pain was 64 (10 to 90). Depression and anxiety were common. Activities were limited mainly because of pain, and the MESS was a valid predictor of the functional outcome. Distal tibial fractures had an increased rate of nonunion when associated with posterior tibial artery damage, and seven patients (39%) were not able to return to their previous occupation.
Authors:
A Soni; K Tzafetta; S Knight; P V Giannoudis
Related Documents :
19653014 - Iliac crest reconstruction to reduce donor-site morbidity: technical note.
22820094 - Strontium signaling: molecular mechanisms and therapeutic implications in osteoporosis.
22833384 - Gnas1 and phd2 short-interfering rna support bone regeneration in vitro and in an in vi...
22784394 - Osteocyte lacunar density and area in newly formed bone of the augmented sinus.
10340864 - Use of reverse triangular v-y flaps to create a web space in syndactyly.
19486634 - Influence of knee flexion on plantarflexion moments after open or percutaneous achilles...
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The Journal of bone and joint surgery. British volume     Volume:  94     ISSN:  0301-620X     ISO Abbreviation:  J Bone Joint Surg Br     Publication Date:  2012 May 
Date Detail:
Created Date:  2012-04-24     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0375355     Medline TA:  J Bone Joint Surg Br     Country:  England    
Other Details:
Languages:  eng     Pagination:  698-703     Citation Subset:  AIM; IM    
Affiliation:
Leeds General Infirmary, Great George Street, Leeds LS1 3EX, UK.
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Descriptor/Qualifier:

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


Previous Document:  Causes and predictors of early re-admission after surgery for a fracture of the hip.
Next Document:  A randomised pilot trial of "locking plate" fixation versus intramedullary nailing for extra-articul...