"open fracture"

INTRODUCTION: Hand fractures are associated with significant morbidity. Current management standards often result in prolonged immobilization, stiffness, and delayed return to functional use. Intramedullary (IM) compression screws offer minimal soft tissue disruption and early postoperative active motion. In this study, we describe our outcomes after intraosseous fracture fixation using IM cannulated headless screws for a multitude of fracture patterns. METHODS: This study is a retrospective review of patients who underwent IM screw placement for fixation of metacarpal and phalangeal fractures by a single surgeon from 2017 to 2022...

Gustilo type III open fractures involve extensive soft tissue damage and wound contamination that pose significant infection risks. The historical standard for antibiotic prophylaxis has been cefazolin and gentamicin. We conducted a retrospective cohort study of lower extremity type III open fractures treated with ceftriaxone alone for prophylaxis. Eighty-six patients were identified. Nearly all (98%) were managed with appropriate antibiotics, but only 55 (64%) received prophylaxis within 1 hour. Overall, there were 12 infections...

We describe a trifocal femur injury with intracapsular femoral neck fracture, diaphyseal fracture with bone loss, and distal complete articular (AO/OTA C type) fracture, an injury rarely described in the literature. Surgical management utilized a not-yet-reported implant combination: screw-side plate device for the intracapsular femoral neck, retrograde nail for the diaphysis, and lag screws plus mini fragment buttress plating for the distal fracture. The patient had uneventful fracture union with no changes in alignment...

Introduction Standard of care management for open fractures historically mandates emergent systemic antibiotic administration, followed by urgent irrigation and debridement in the operating room, regardless of injury severity. However, significant controversy exists regarding the specific implementation and importance of these commonly accepted guidelines. We aimed to define differences in the management of grade 1 open distal radius fractures. Methods An anonymous online survey was distributed to attending surgeon members of either the Orthopaedic Trauma Association (OTA) between January 2019 and April 2019 or the New York Society for Surgery of the Hand (NYSSH) in January 2019...

PURPOSE: To identify factors associated with delays in administration and pharmacy and nursing preparation of antibiotics for patients with open fractures. DESIGN: Retrospective review. SETTING: Level I trauma center. PATIENTS: Nine hundred sixty-three adults with open fractures administered antibiotics. MAIN OUTCOME MEASUREMENTS: Delay in antibiotic administration greater than 66 minutes from arrival and significant pharmacy-related and nursing-related delay...

Percutaneous needle decompression (PND) can be a successful alternative to open fasciotomies for acute compartment syndrome (ACS). We present the case of a 45-year-old male patient who survived a road traffic accident and developed ACS following his open fracture of the tibia and fibula. He was treated by performing PND on all compartments of the affected leg using a 24 gauge needle thus avoiding the complications of a double incision fasciotomy.

Introduction Amputations and recurrent infections are two terrible outcomes of open fractures that can leave patients with permanent impairments. Rapid and effective treatment can protect patients from open fracture sequelae and the long-term financial burden these injuries frequently cause. Over 50% of open fractures are caused by high energy trauma, which most frequently happens in car accidents or severe falls. There hasn't been much research done on the first bacterial ecology of open fracture wounds in the Indian environment...

AIMS: Ankle fractures are common injuries and the third most common fragility fracture. In all, 40% of ankle fractures in the frail are open and represent a complex clinical scenario, with morbidity and mortality rates similar to hip fracture patients. They have a higher risk of complications, such as wound infections, malunion, hospital-acquired infections, pressure sores, veno-thromboembolic events, and significant sarcopaenia from prolonged bed rest. METHODS: A modified Delphi method was used and a group of experts with a vested interest in best practice were invited from the British Foot and Ankle Society (BOFAS), British Orthopaedic Association (BOA), Orthopaedic Trauma Society (OTS), British Association of Plastic & Reconstructive Surgeons (BAPRAS), British Geriatric Society (BGS), and the British Limb Reconstruction Society (BLRS)...

INTRODUCTION: Treatment of posterior malleolar (PM) ankle fractures remains controversial. Despite increasing recommendation for small PM fragment fixation, high quality evidence demonstrating improved clinical outcomes over the unfixated PM is limited. We describe the long term clinical and radiographical outcomes in younger adult patients with PM ankle fractures managed without PM fragment fixation. MATERIAL AND METHODS: A retrospective cohort study was performed on PM ankle fracture patients aged 18-55 years old admitted under our orthopaedic unit between 1st of April 2009 and 31st of October 2013...

BACKGROUND: Open fractures with extensive soft-tissue damage, significant periosteal stripping, and exposed bone ends pose a significant challenge in orthopaedics. So, we conducted a prospective study that investigated the efficacy of vacuum-assisted closure (VAC) therapy in improving functional outcomes for orthopaedic open wounds. METHODS: A prospective case series was conducted for a period of 18 months at the department of orthopaedics. Seventeen patients with open wounds were included in the study after fulfilling specific criteria...

BACKGROUND: The COVID-19 pandemic drove many healthcare systems worldwide to postpone elective surgery to increase healthcare capacity, manpower and reduce infection risk to staff. The aim of this study was to assess the impact of an elective surgery postponement policy in response to the COVID-19 pandemic on surgical volumes and patient outcomes for 3 emergency bellwether procedures. METHODS: A retrospective cohort study of patients who underwent any of the 3 emergency procedures (Caesarean section (CS), emergency laparotomy (EL) and open fracture (OF) fixation) between 1 January 2018 to 31 December 2021 was conducted using clinical and surgical data from electronic medical records...

BACKGROUND: For the temporary treatment of ankle fracture dislocations (AFDs), previous studies indicate higher rates of secondary loss of reduction (LOR) with splint immobilization, prompting consideration for expanding indications for external fixation (ExFix). However, these studies did not investigate the influence of fracture morphology to further improve patient selection. The aim of this study was to investigate the influence of Lauge-Hansen injury type on the LOR rate in bimalleolar or trimalleolar AFDs for temporary cast vs ExFix immobilization...

AIM: To evaluate the management of patients with severe open tibial fractures at major trauma centres (MTCs) in the UK with respect to BOAST 4 guidelines. METHODS: Data collected by the Trauma and Audit Research Network (TARN) for all severe open tibial fractures treated at the 23 adult MTCs were evaluated. Key performance indicators (KPIs) included MTC admission under orthoplastics, administration of antibiotics within three hours of injury, initial debridement within 24 h and definitive fixation and soft tissue coverage within 72 h...

BACKGROUND: Plastic surgery (PS) in Africa is a relatively young surgery specialty, and the number of available plastic surgeons on average is one or two surgeons per country in many African low-income countries. This systematic review aims to geographically map the research activities through scientific publications of African PS centres, between February 2012-February 2023. METHODS: We searched four literature databases (Medline, Embase, Google Scholar and African Journal Online) and did a manual search...

OBJECTIVES: To determine if a multi-disciplinary institutional protocol can optimize the time to antibiotic (Abx) administration for open fractures (openFx) and improve compliance with the administration of Abx prophylaxis during trauma activation. METHODS: Design: Retrospective pre-post study design. SETTING: Single Level II Trauma Center. PATIENT SELECTION CRITERIA: All patients that triggered a trauma activation with suspected openFx and were treated according to the institutional single antibiotic regimen were eligible for inclusion...

OBJECTIVES: To determine the early implant failure rate of a novel retrograde intramedullary femoral nail. METHODS: Design: Retrospective matched case control. SETTING: Academic level 1 trauma center. PATIENTS SELECTION CRITERIA: Patients 18 years and older with an acute AO/OTA 32-A, 32-B, 32-C, and 33-A fracture or periprosthetic distal femur fracture from April 2018 to April 2022 were included in the study. The two interventions compared were the Synthes Expert Retrograde/antegrade femoral nail (RAFN or control implant) versus the next generation RFN-Advanced retrograde femoral nail (RFNA or experimental implant) (Synthes, West Chester, PA)...

OBJECTIVES: To evaluate the timing of definitive fixation of tibial plateau fractures relative to fasciotomy closure with regards to alignment and articular reduction. METHODS: Design: Retrospective Case Series. SETTING: Four Level I trauma centers. PATIENT SELECTION CRITERIA: Patients with tibial plateau fractures with ipsilateral compartment syndrome treated with fasciotomy between 2006-2018 met inclusion criteria...

Background Open fractures are common and serious injuries that primarily affect young males. Fracture management has improved in the last decade. However, infections with their complications are still a concern, especially in open fractures for primary closure of the injured area. A newer technique called vacuum-assisted therapy has become a therapy of choice for many orthopedic surgeons. This study aimed to determine whether vacuum-assisted closure reduces the duration of wound healing and the frequency of infections after fixation of Gustilo-Anderson Type IIIA/IIIB fractures of the extremities...

BACKGROUND: Serratia marcescens ( S. marcescens ) is an unusual cause of osteomyelitis. Infection may develop following open trauma, intravenous drug abuse, or in the presence of hardware, but osteoarticular infections outside of this context are atypical in the absence of immunodeficiency. Rarely, a chronic indolent infection may develop after open trauma with disease recurrence years after the initial injury. CASE DESCRIPTION: We present the case of a 16-year-old male with extensive left lower extremity osteomyelitis secondary to S...

AIM: This study aimed to quantitatively summarise risk factors associated with surgical site infection (SSI) following surgically managed tibial fractures. METHOD: We searched the Embase/Medline, Cochrane Library, and Scopus databases for relevant studies in October 2023. We included original studies investigating risk factors for SSI following surgically managed traumatic tibial fractures that included ≥10 adult patients with SSIs. Meta-analysis was performed when >5 studies investigated the same risk factor...