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ISSN 2992-8036 (Electronic)
ISSN 2306-4102 (Print)
Órgano Oficial del Colegio Mexicano de Ortopedia y Traumatología

2001, Number 6

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Acta Ortop Mex 2001; 15 (6)

Epidemiology and clinical results of tibial exposed fractures

Ruiz-Martínez F, Caldelas-Cuéllar E, Sánchez SM

Language: Spanish
References: 35
Page: 288-295
PDF size: 135.04 Kb.


ABSTRACT

A series of 285 adult patients between 15 and 95 years of age who were admitted because of open fractures of the tibia is reported. Fracture was dyaphyseal in 211 cases (74%) and more common fracture was with third fragment (butterfly). First debridement was performed before 8 hours in only 49.8%. Bone stabilizing was by external fixation in 36.1% and by intramedullary nailing in 41.9%. Bone union was achieved in an average of 30.6 weeks. Main complications were delayed union in 13.4%, mal-union in 13.4% and osteitis in 11%.


REFERENCES

  1. Abramowitz A, Wetzler MJ, Levy AS, Whitelaw GP: Treatment of open tibial fractures with ender rods. Clin Orthop 1993; 293: 246-55.

  2. Adrover PA, Garin DM, Alvarez JM, Alonso CP: External fixation and secondary intramedullary nailing of open tibial fractures. J Bone Joint Surg 1997; 79B: 433-7.

  3. American Academy of Orthopedic Surgeons. Orthopedic knowledge Update 5. Masson Caps 1997; 39-40: 465-94.

  4. Bartlett CS, Weiner LS, Yang EC: Treatment of type II and type III open tibia fractures in children. J Orthop Trauma 1997; 11(5): 357-62.

  5. Bonatus T, Olson SA, Lee S, Chapman MW: Nonreamed locking intramedullary nailing for open fractures of the tibia. Clin Orthop 1997; 339: 58-64.

  6. Browner BD, Jupiter JB, Levin AM, Traftton PG: Skeletal trauma. Volume Two. WB. Saunders Company Chapter 1992; 51: 1771-870.

  7. Caudle RJ, Stern PJ: Severe open fractures of the tibia. J Bone Joint Surg 1987; 69A: 801-7.

  8. Colchero RF: Manual de infecciones óseas. Edit. Trillas 1995.

  9. Cole JD, Ansel LJ, Schwartzberg R: A sequential protocol for management of severe open tibial fractures. Clin Orthop 1995; 315: 84-103.

  10. Court-Brown CM, McQueen MM, Quaba AA, Christie J: Locked intramedullary nailing of open tibial fractures. J Bone Joint Surg 1991; 73B: 959-64.

  11. Court-Brown CM, Whellwright EF, Christie J, Mcquenn MM: External fixation for type III open tibial fractures. J Bone Joint Surg 1990; 72B: 801-4.

  12. Crenshaw AH: Campbell cirugía ortopédica. Edit. Médica Panamericana. Cap 44, 1988.

  13. Dee R, Hurst LC, Gruber MA, Kottmeier SA: Principles of orthopedic practice, second edition. Mc Graw-Hill 1997; 29: 519-30.

  14. Georgiadis GM, Behrens FF, Joyee MJ, Earle AS, Simmons AL: Open tibial fractures with severe soft-tissue loss. J Bone Joint Surg 1993; 75A: 1431-41.

  15. Gustilo RB, Anderson JT. Prevention of the infection in the treatment of one thousand and twenty-five open fractures of long bones. Retrospective and prospective analyses. J Bone Joint Surg 1976; 58A: 453-8.

  16. Gustilo RB, Merkow RL, Templeman D: Current concepts review the management of open fractures. J Bone Joint Surg 1990; 299-304.

  17. Hansen ST: The type IIIC tibial fractures (Editorial). J Bone Joint Surg 1987; 69A: 799-800.

  18. Jain R, Podworny N, Hearn T, Anderson GI, Schemitsch EH: Effect of stainless steel and titanium low contact plate application on the vascularity and mechanical properties of cortical bone after fracture. J Orthop Trauma 1997; 11 (7): 490-5.

  19. Keating JF, Kuo RS, Court-Brown CM: Bifocal fractures of the tibia and fibula. Incidence, classification and treatment. J Bone Joint Surg 1994; 76B: 395-400.

  20. Xeating JF, O’Brien PI, Balchut PA, Meek RN, Broekhuyse HM: Reamed interlocking intramedullary nailing of open fractures of the tibia. Clin Orthop 1997; 338: 182-91.

  21. Levy AS, Wetzler M, Lewars M, Bromberg J, Spoo J, Whitelaw GP: The orthopedic and social outcome of open tibial fractures in children. Orthopedics 1997; 20(7): 593-8.

  22. Müller ME, Allgower M, Schneider R, Willinegger H: Manual of internal fixation techniques recomended by the AO group. Edition 4, Berlin, Springer Verlag 1994.

  23. Patzakis M, Harvey JIP, Ivler D: The role of antibiotics in the management of open fractures. J Bone Joint Surg 1974; 56A: 532-41.

  24. Patzakis M, Wilkins J, Moore TM: Considerations in reducing the infection rate in open tibial fractures. Clin Orth 1983; 178: 36-41.

  25. Russell GG, Henderson R, Arnett G: Primary or delayed closure for open tibial fractures. J Bone Joint Surg 1990; 72B: 125-8.

  26. Sargeant ID, Lovell M, Casserley H, Green ADL: The AO unreamed tibial nail: A 14 months follow-up of the 1992 TT experience. Injury 1994; 25 (7): 423-5.

  27. Sarmiento A, Gersten LM, Sobol PA, Shankwiler JA, Vangsness CT: Tibial shaft fractures treated with functional braces. J Bone Joint Surg 1989; 71B: 602-9.

  28. Seligson D, Ostermann PAW, Henry SL, Wolley T: The management of open fractures associated with arterial injury requiring vascular repair. J Trauma 1994; 37 (6): 938-40.

  29. Siebenrock KA, Gerich T, Jakob RP: Sequential intramedullary nailing of open tibial shaft fractures after external fixation. Arch Orthop Trauma Surg 1997; 116: 32-6.

  30. Torneta P, Bergman M, Watnik N, Berkowitz G: Treatment of grade IIIB open tibial fractures. J Bone Joint Surg 1994; 76B: 13-9.

  31. Tu YK, Lin CH, Su JI, Hsu DT, Chen RJ: Unreamed interlocking nail versus external fixator for open type III tibia fractures. J Trauma 1995; 39 (2): 361-7.

  32. Tucker HL, Kendra JC, Kinnebrew TE: Management of unstable open and closed tibial fractures using the Ilizarov method. Clin Orthop 1992; 280: 125-35.

  33. Whitelaw GP, Wetzler M, Nelson A, Segal D, Fletcher J, Hadley N, Sawka M: Ender rods versus external fixation in the treatment of open tibial fractures. Clin Orthop 1990; 253: 258-69.

  34. Whittie P, Russell TA, Taylor JC, Lavelle DG: Treatment of open fractures of the tibial shaft with the use of interlocking nailing without reaming. J Bone Joint Surg 1992; 74A: 1162-71.

  35. Wiss DA, Stetson WB: Unstable fractures of the tibia treated with a reamed intramedullary interlocking nail. Clin Orthop 1995; 315: 56-63.




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