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Gustilo Anderson

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https://www.readbyqxmd.com/read/28904637/the-emerging-trend-of-non-operative-treatment-in-paediatric-type-i-open-forearm-fractures
#1
REVIEW
H Zhang, M Fanelli, C Adams, J Graham, M Seeley
PURPOSE: Open fractures are considered an orthopaedic emergency and are generally an indication for operative debridement. Recent studies have questioned this approach for the management of Gustilo-Anderson Type I open fractures in the paediatric population. This meta-analysis studies the non-operative management of Type I open paediatric forearm fractures. METHODS: An Ovid MEDLINE and PubMed database literature search was performed for studies that involved a quantified number of Gustilo-Anderson Type I open forearm fractures in the paediatric population, which were treated without operative intervention...
August 1, 2017: Journal of Children's Orthopaedics
https://www.readbyqxmd.com/read/28893227/damage-control-surgery-experiences-from-a-level-i-trauma-center
#2
Bernhard Gasser, Thomas M Tiefenboeck, Sandra Boesmueller, Danijel Kivaranovic, Adam Bukaty, Patrick Platzer
BACKGROUND: There is still no evidence in literature for damage control orthopaedics (DCO), early total care (ETC) or using external fixation solely in fractures of the long bones in multi-system-trauma. The aim of this study was to determine parameters influencing the choice of treatment in clinical routine (DCO, ETC, or EF) in femoral or tibial shaft fractures in combination with multi-system-trauma, severe soft tissue damage or both. METHODS: Data of 236 patients with 280 fractures of long bones of the lower extremities treated at a level I trauma center were analysed...
September 11, 2017: BMC Musculoskeletal Disorders
https://www.readbyqxmd.com/read/28888404/expert-tibial-nails-for-treating-distal-tibial-fractures-with%C3%A2-soft%C3%A2-tissue%C3%A2-damage-a-patient-series
#3
Zhenhai Wang, Yiheng Cheng, Dajiang Xin, Tong Liu, Wenqing Qu, Dan Wang, Yong Zhao, Jingjing Zhao
Distal tibial fractures with soft tissue damage are relatively difficult to treat. We assessed the outcomes of patients with these fractures treated with Expert Tibial Nails(®) (DePuy Synthes, Raynham, MA) from March 2012 to December 2014. At 6 months postoperatively, the general health quality of patients was assessed using operative time, interval to return to work, American Orthopaedic Foot and Ankle Society ankle scale score, pain measured using a visual analog scale, and short-form health outcomes 36-item survey physical functioning and mental health dimension scores...
September 7, 2017: Journal of Foot and Ankle Surgery: Official Publication of the American College of Foot and Ankle Surgeons
https://www.readbyqxmd.com/read/28862056/the-use-of-engineered-bilayered-skin-myderm-tm-in-the-management-of-massive-skin-defect-in-grade-iii-gustilo-anderson-open-fracture
#4
Nor Hazla Mohamed Haflah, Min Hwei Ng, Mohd Heikal Mohd Yunus, Amaramalar Selvee Naicker, Ohnmar Htwe, Muhammad Fahmi, Mohamad Fikeri Ishak, Wan Tai Seet, Khairul Anuar Khairoji, Manira Maarof, Kien Hui Chua, Sharen Aini Shamsuddin, Ruszymah Idrus
Open fracture Gustilo-Anderson grade IIIC is associated with higher risk of infection and problems with soft tissue coverage. Various methods have been used for soft tissue coverage in open fractures with large skin defect. We report a case of a patient who had grade IIIC open fracture of the tibia with posterior tibial artery injury. The patient underwent external fixation and reduction. Because of potential compartment syndrome after vascular repair, fasciotomy of the posterior compartment was performed. This wound, however, became infected and because of further debridement, gave rise to a large skin defect...
September 1, 2017: International Journal of Lower Extremity Wounds
https://www.readbyqxmd.com/read/28819607/a-gustilo-type-3b-open-tibial-fracture-treated-with-a-proximal-flexor-hallucis-longus-flap-a-case-report
#5
Tomohiro Yasuda, Masayuki Arai, Kaoru Sato, Koji Kanzaki
INTRODUCTION: In the treatment of Gustilo Type 3B open tibial fractures, it is important to perform soft tissue reconstruction and bone reconstruction simultaneously. Gastrocnemius muscle and soleus muscle flaps are generally used as rotational flaps for the tibia. The distal third of the tibia can often not be covered with the gastrocnemius muscle and soleus muscle flaps. Treatment distal to the distal third of the tibia is difficult because fewer flap options are available. In the present report, we describe our experience with a Gustilo Type 3B open tibial fracture treated by gastrocnemius muscle and soleus muscle flaps, along with an additional proximally based flexor hallucis longus flap, which is a rare procedure...
March 2017: Journal of Orthopaedic Case Reports
https://www.readbyqxmd.com/read/28808625/epidemiology-of-open-fractures-in-sport-one-centre-s-15-year-retrospective-study
#6
Alexander M Wood, Greg A J Robertson, Kirsty MacLeod, Anna Porter, Charles M Court-Brown
AIM: To describe the epidemiology of sport-related open fractures from one centre's adult patient population over a 15-year period. METHODS: A retrospective review of a prospectively-collected database was performed: The database contained information all sport-related open fractures, sustained from 1995 to 2009 in the Edinburgh, Mid and East Lothian Populations. RESULTS: Over the 15-year period, there were 85 fractures recorded in 84 patients...
July 18, 2017: World Journal of Orthopedics
https://www.readbyqxmd.com/read/28808593/combined-bone-transportation-and-lengthening-techniques-for-the-treatment-of-septic-nonunion-of-the-forearm-followed-by-tendon-transfer
#7
Konstantinos Ditsios, Eirini Iosifidou, Lazaros Kostretzis, Panagiotis Konstantinou, Iosafat Pinto, Ioannis Theodoroudis, Ippokratis Hatzokos
Infected nonunion of a forearm fracture complicated by a considerable skin-muscle defect poses a great challenge to orthopaedic surgeons. The treatment strategy comprises eradication of the infection, ensuring bony union and soft tissue coverage along with functional restoration. We report a case of a 23-year-old man with an open Gustilo-Anderson IIIb fracture complicated by infected nonunion after internal fixation. After thorough surgical debridement, a considerable soft tissue defect, extensor muscle loss, and posterior interosseous nerve laceration had to be addressed...
2017: Case Reports in Orthopedics
https://www.readbyqxmd.com/read/28744800/risk-factors-for-infectious-complications-after-open-fractures-a-systematic-review-and-meta-analysis
#8
REVIEW
Kirsten Kortram, Hans Bezstarosti, Willem-Jan Metsemakers, Michael J Raschke, Esther M M Van Lieshout, Michael H J Verhofstad
PURPOSE: The purpose of this study was to identify risk factors for the development of infection after open fracture fixation. METHODS: A comprehensive search in all scientific literature of the last 30 years was performed in order to identify patient-, trauma-, diagnosis- and treatment-related risk factors. Studies were included when infectious complications were assessed in light of one or more risk factors. A meta-analysis was performed. Risk ratios (RR) or risk differences (RD) with 95% confidence intervals were calculated...
July 25, 2017: International Orthopaedics
https://www.readbyqxmd.com/read/28678121/predicting-and-preventing-loss-to-follow-up-of-adult-trauma-patients-in-randomized-controlled-trials-an-example-from-the-flow-trial
#9
RANDOMIZED CONTROLLED TRIAL
Kim Madden, Taryn Scott, Paula McKay, Brad A Petrisor, Kyle J Jeray, Stephanie L Tanner, Mohit Bhandari, Sheila Sprague
BACKGROUND: High loss-to-follow-up rates are a risk in even the most rigorously designed randomized controlled trials (RCTs). Consequently, predicting and preventing loss to follow-up are important methodological considerations. We hypothesized that certain baseline characteristics are associated with a greater likelihood of patients being lost to follow-up. Our primary objective was to determine which baseline characteristics are associated with loss to follow-up within 12 months after an open fracture in adult patients participating in the Fluid Lavage of Open Wounds (FLOW) trial...
July 5, 2017: Journal of Bone and Joint Surgery. American Volume
https://www.readbyqxmd.com/read/28652756/noncontact-plating-technique-in-an-open-fracture
#10
Ümit Tuhanioğlu, Hasan Ulaş Oğur, Hakan Çiçek, Fırat Seyfettinoğlu, Osman Çiloğlu, Ahmet Kapukaya
AIM: In comparison with closed fractures, open fractures have an increased risk of infection, there are soft tissue-related problems, and difficulties are experienced in union. The aim of this study was to evaluate and discuss the results of osteosynthesis applied with a noncontact plate in Gustilo-Anderson Type 2, 3a, and 3b fractures. METHOD: The study included 23 patients applied with debridement + noncontact plate osteosynthesis + soft tissue procedures in a single session for the treatment of an open fracture...
2017: Therapeutics and Clinical Risk Management
https://www.readbyqxmd.com/read/28571220/interlocking-nailing-versus-plating-in-tibial-shaft-fractures-in-adults-a-comparative-study
#11
Sagnik Mukherjee, Mahendra Singh Arambam, Sanjib Waikhom, Santosha, Pranav Vitthal Masatwar, Rohan Gautam Maske
INTRODUCTION: Tibial diaphyseal fractures are the commonest long bone fractures in adults, most commonly managed by intramedullary interlocking nailing. However, several meta-analysis show that locking plate osteosynthesis is equally effective in managing tibial diaphyseal fractures and are associated with less number of complications. AIM: To compare the results of fixation of tibial fractures following plating and nailing in terms of union, patient satisfaction and complications...
April 2017: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28566784/management-of-open-fractures-using-a-noncontact-locking-plate-as-an-internal-fixator
#12
Azad Yıldırım, Ahmet Kapukaya, Yılmaz Mertsoy, Şehmus Yiğit, Mehmet Akif Çaçan, Ramazan Atiç
BACKGROUND: The treatment of open fractures leads to major problems which may be due to various reasons. It mainly causes soft tissue problems due to the absorption of a large amount of energy by the soft tissues and bone tissues. Although some recent treatment protocols have eliminated many problems regarding delayed soft tissue closure, it still remains a big challange. This study uses a method called the internal fixator technique with noncontact locking plate (NC-LP) which involves the use of a combination of advantages of open and closed fixation techniques...
May 2017: Indian Journal of Orthopaedics
https://www.readbyqxmd.com/read/28509409/soft-tissue-reconstruction-and-salvage-of-infected-fixation-hardware-in-lower-extremity-trauma
#13
Hyuma A Leland, Alexis D Rounds, Karen E Burtt, Daniel J Gould, Geoffrey S Marecek, Ram K Alluri, Ketan M Patel, Joseph N Carey
BACKGROUND: Tibial fracture management may be complicated by infection of internal fixation hardware (iIFH) resulting in increased morbidity and amputation rate. When iIFH removal is not possible, salvage of the lower extremity is attempted through debridement, antibiotics, and vascularized soft tissue coverage. This study investigates lower extremity salvage with retention of iIFH. METHODS: Demographics, outcomes, and bacterial speciation in patients with tibial fractures at a level 1 trauma center from 2007 to 2014 were reviewed...
May 16, 2017: Microsurgery
https://www.readbyqxmd.com/read/28400675/erratum-management-of-gustilo-anderson-iii-b-open-tibial-fractures-by-primary-fascio-septo-cutaneous-local-flap-and-primary-fixation-the-fix-and-shift-technique
#14
(no author information available yet)
[This corrects the article on p. 55 in vol. 51, PMID: 28216752.].
March 2017: Indian Journal of Orthopaedics
https://www.readbyqxmd.com/read/28394750/impact-of-body-mass-index-and-bacterial-resistance-in-osteomyelitis-after-antibiotic-prophylaxis-of-open-lower-extremity-fractures
#15
Derek Bremmer, Brandon Bookstaver, Mark Cairns, Kenneth Lindley, Martin Durkin, David Koon, April Miller Quidley
BACKGROUND: We investigated the clinical effectiveness of antimicrobial prophylaxis in lower-extremity open fractures following the Eastern Association for the Surgery of Trauma Guidelines. METHODS: This observational, retrospective, single-center study included adults with lower-extremity open fractures of the ankle, tibia, fibula, or femur. The primary endpoint was the incidence of osteomyelitis within 12 months of the fracture. Secondary endpoint comparisons were the time of antibiotic initiation and drug selection...
April 2017: Surgical Infections
https://www.readbyqxmd.com/read/28387196/bone-grafting-via-reamer-irrigator-aspirator-for-nonunion-of-open-gustilo-anderson-type-iii-tibial-fractures-treated-with-multiplanar-external-fixator
#16
Nicholas Kusnezov, Gautham Prabhakar, Matthew Dallo, Ahmed M Thabet, Amr A Abdelgawad
INTRODUCTION: The purpose of this investigation was to evaluate the outcomes following reamer-irrigator-aspirator (RIA) autogenous bone grafting (ABG) of high-grade open tibia fracture nonunions stabilized via multiplanar external fixation. METHODS: We retrospectively reviewed all patients with Gustilo-Anderson type III open tibia fractures treated with multiplanar external fixation and who underwent RIA ABG for nonunion at our institutional Level 1 Trauma Center between 2008 and 2015...
2017: SICOT-J
https://www.readbyqxmd.com/read/28385946/the-management-of-open-tibial-fractures-in-children-a-retrospective-case-series-of-eight-years-experience-of-61-cases-at-a-paediatric-specialist-centre
#17
R S Nandra, F Wu, A Gaffey, C E Bache
AIMS: Following the introduction of national standards in 2009, most major paediatric trauma is now triaged to specialist units offering combined orthopaedic and plastic surgical expertise. We investigated the management of open tibia fractures at a paediatric trauma centre, primarily reporting the risk of infection and rate of union. PATIENTS AND METHODS: A retrospective review was performed on 61 children who between 2007 and 2015 presented with an open tibia fracture...
April 2017: Bone & Joint Journal
https://www.readbyqxmd.com/read/28303249/a-descriptive-study-of-open-fractures-contaminated-by-seawater-infection-pathogens-and-antibiotic-resistance
#18
Hongyi Zhu, Xingwei Li, Xianyou Zheng
Aims. In this work, the main objectives were to investigate the clinical characteristics and bacterial spectrum present in open fractures contaminated by seawater. Methods. We conducted a retrospective cohort study and included all patients with open fractures from 1st January, 2012, to 31st December, 2015, in our hospital. Patients were grouped based on the presence of seawater contamination in wounds. We compared the infection rate, bacterial spectrum, and antibiotic resistance between the two groups. Results...
2017: BioMed Research International
https://www.readbyqxmd.com/read/28216752/management-of-gustilo-anderson-iii-b-open-tibial-fractures-by-primary-fascio-septo-cutaneous-local-flap-and-primary-fixation-the-fix-and-shift-technique
#19
P R Ramasamy
BACKGROUND: Open fractures of tibia have posed great difficulty in managing both the soft tissue and the skeletal components of the injured limb. Gustilo Anderson III B open tibial fractures are more difficult to manage than I, II, and III A fractures. Stable skeletal fixation with immediate soft tissue cover has been the key to the successful outcome in treating open tibial fractures, in particular, Gustilo Anderson III B types. If the length of the open wound is larger and if the exposed surface of tibial fracture and tibial shaft is greater, then the management becomes still more difficult...
January 2017: Indian Journal of Orthopaedics
https://www.readbyqxmd.com/read/28199292/management-of-open-tibial-shaft-fractures-does-the-timing-of-surgery-affect-outcomes
#20
Oscar A Duyos, David Beaton-Comulada, Ariel Davila-Parrilla, Jose Carlos Perez-Lopez, Krystal Ortiz, Christian Foy-Parrilla, Francisco Lopez-Gonzalez
BACKGROUND: Open tibial shaft fractures require emergent care. Treatment with intravenous antibiotics and fracture débridement within 6 to 24 hours is recommended. Few studies have examined outcomes when surgical treatment is performed >24 hours after occurrence of the fracture. METHODS: This retrospective study included 227 patients aged ≥18 years with isolated open tibial shaft fractures in whom the time to initial débridement was >24 hours. The statistical analysis was based on time from injury to surgical débridement, Gustilo-Anderson classification, method of fixation, union status, and infection status...
March 2017: Journal of the American Academy of Orthopaedic Surgeons
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