Document Detail


Reconstruction of Nonunion Tibial Fractures in War-Wounded Iraqi Civilians, 2006-2008: Better Late Than Never.
MedLine Citation:
PMID:  22249770     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
OBJECTIVE:: To describe medical care and surgical outcome after functional reconstructive surgery in late-presenting patients who already had at least one prior operation. DESIGN:: Retrospective review of medical care and surgical outcome from August 2006 to December 2008 using patient records for initial data with active follow-up for the latest outcome information. SETTING:: Médecins sans Frontières surgical programme in Jordan Red Crescent Hospital, Amman, Jordan. PATIENTS:: Sixty-two civilians with nonunion tibial fractures caused by war-related trauma in Iraq; 53 completed follow-up. INTERVENTION:: Amputation and/or reconstruction. MAIN OUTCOME MEASUREMENTS:: Late surgical complications (after the patient's return to Iraq) were analyzed for infection recurrence, bone union, and functional condition (defined using the Short Musculoskeletal Functional Assessment score). RESULTS:: Almost three fourths of patients arrived with infected injuries, nine of whom had amputation as the initial surgery; the rest, and all uninfected patients, had reconstruction. Excluding loss to follow-up, only four of 53 (8%) patients who arrived with an infected injury had infection recurrence. Excluding loss to follow-up and amputation, two of 14 (14%) patients in the uninfected and five of 30 (17%) in the infected injury group did not achieve successful tibial union. Mean Dysfunctional and Bothersome Indices overall were 27.1 and 29.8, respectively, with similar results for all three groups (amputations, uninfected, and infected injuries). CONCLUSIONS:: Our study shows that patients with infected and uninfected injuries surgically treated in Amman achieved similar outcomes. Despite late presentation, our patients had a comparable outcome to other studies dealing with early reconstruction. Reconstruction for the infected group required longer treatment time.
Authors:
Rasheed M Fakri; Ali M K Al Ani; Angela M C Rose; Majd S Alras; Laurent Daumas; Emmanuel Baron; Sinan Khaddaj; Patrick Hérard
Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-1-10
Journal Detail:
Title:  Journal of orthopaedic trauma     Volume:  -     ISSN:  1531-2291     ISO Abbreviation:  -     Publication Date:  2012 Jan 
Date Detail:
Created Date:  2012-1-17     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8807705     Medline TA:  J Orthop Trauma     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Affiliation:
From *Médecins sans Frontières, Paris, France; †Chronic Disease Research Centre, University of the West Indies, Bridgetown, Barbados; ‡Epicentre, Paris, France; and §Women and Health Alliance (WAHA) International, Paris, France.
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