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Órgano Oficial del Colegio Mexicano de Ortopedia y Traumatología

2001, Number 3

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Acta Ortop Mex 2001; 15 (3)

Exposed fractures: their classification and external fixation. Options for the third World (developing countries)

Aybar MA

Language: Spanish
References: 39
Page: 95-108
PDF size: 155.59 Kb.


ABSTRACT

Background. In regards to the classifications of fractures, any pattern should be safe, reliable and reproducible. For the daily clinical work, it should also be of simple application. About these recommendations, the Gustilo classification continues being questioned. Objectives. The special of the present study is to demonstrate an alternative for open fractures classification that point out to the concepts recommended, and to demonstrate propose a disposable external fixator as simple, safe and inexpensive method, for all the options of open fractures and for any special procedure of external fixation. Methods. Characteristics of soft tissues damage taking fundamentally into account their dimension in thirds, in three stages were considered on one hand. On the other, the characteristics of the configuration fracture line according to the X-ray classifies them in four groups, according to their complexity. Both characteristics were intertwined. It was also considered the moment of the initial treatment, in three stages. All these characteristics were put in a portable screen recording without exclusions 125 open fractures of the tibial shaft, during four consecutive years. All were immobilized by disposable external fixation. During the treatment the number of operative acts until their cure, the difficulties, the complications, the time of consolidation and their sequels were registered postoperative the follow-up range, was from 11 months to 10 years. Results. All fractures were clearly diagnosed. The difficulties in the achievement of reduction and in the achievement of immobilization as well as the times of consolidation were proportional to the classification scale. The operative technique and the implant material implants for the disposable external fixation was at reach of all the options of fractures, within reach of any patient, whether in the rural areas or in the big cities. Conclusions. The diagnosis was quick and easy, and it was located inside 15 probabilities with characteristics very well defined at point to that established in classification. In clinical practice, this classification alternative as well as the disposable external fixation technique demonstrated to be functional.


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