Radical treatment of severe open fractures of extremities by orthoplastic surgery: a 10-year retrospective study

Journal of Orthopaedic Surgery and Research

Lei Shang¹  Zhao Yang²  Dan-Min Miao²  Jun Li³  Zi-Xiang Wu³  Yong-Gang Zhu³  Bao-Bao Xue³  Ji-Wei Zou³  Chao Xu³  Guang-Yue Zhao³ 

[1] Department of Health Statistics, Faculty of Preventive Medicine, Air Force Military Medical University, No. 169 Changle Xi Road, 710032, Xi’an, Shaanxi Province, People’s Republic of China;Department of Military Medical Psychology, Air Force Military Medical University, No. 169 Changle Xi Road, 710032, Xi’an, Shaanxi Province, People’s Republic of China;Department of Orthopeadic Surgery, Xijing Hospital, Air Force Military Medical University, No. 127 Changle Xi Road, 710032, Xi’an, Shaanxi Province, People’s Republic of China;

关键词: Soft tissue reconstruction;    Severe open fractures;    Orthoplastic;    Masqualet;   

DOI  :  10.1186/s13018-021-02479-2

来源: Springer

【 摘 要 】

ObjectiveThis study aimed to retrospectively analyze clinical data of a series of patients with severe open fractures of extremities (Gustilo IIIb or IIIc), who achieved a satisfactory outcome through radical orthoplastic surgery, so as to provide a reference for determining the treatment of severe open fractures of extremities.MethodsThe clinical data of 41 consecutive patients with severe open fracture (Gustilo IIIb or IIIc) of the limb, who underwent successful surgical debridement, fixation, and soft tissue reconstruction in one stage between January 2008 and January 2019, were retrospectively reviewed. Postoperative indicators, including infection rate and union time, were acquired by a regular follow-up and analyzed.ResultsThe mean (±SD) age of the patients was 38 ± 16 years. A total of 90 open fractures and severe soft tissue damages were analyzed. The soft tissue cover was achieved within 72 h. The overall rate of infection was 14.6% (6/41). Sex and the Mangled Extremity Severity Score were associated with infection. The median union time of 40 patients (one amputation) was 32 weeks.ConclusionThe overall rate of infection exhibited a lower tendency in this study compared with previous studies on high-grade open fractures following a two-stage orthopedic approach. The consequence of infection rate and union time was similar to that in previous studies. These results indicated that the single-stage radical orthoplastic treatment was an effective and reliable option for reconstructing severe open fractures.

【 授权许可】

CC BY