Functional outcomes of traumatic lower extremity reconstruction.
Ambulation
Fractures
Lower extremity
Open
Surgical flaps
Tibial fractures
Journal
Journal of clinical orthopaedics and trauma
ISSN: 0976-5662
Titre abrégé: J Clin Orthop Trauma
Pays: India
ID NLM: 101559469
Informations de publication
Date de publication:
Historique:
received:
23
05
2017
accepted:
17
08
2017
entrez:
2
2
2019
pubmed:
2
2
2019
medline:
2
2
2019
Statut:
ppublish
Résumé
Lower extremity trauma accounts for over 300,000 injuries annually. While soft tissue transfer is a well-accepted practice for open fracture coverage, functional outcomes remain unclear. This study investigates functional outcomes following soft tissue reconstruction for open tibial fractures. A retrospective review of a prospectively maintained database of open tibia fractures requiring soft tissue reconstruction was performed at an urban level 1 trauma center between October 2013 and March 2015. were evaluated using Pearson's chi square test with significant p value < 0.05. In 30 patients, fractures were graded Gustilo-Anderson type I (3.3%), 30% type II, 3.3% type IIIa, 53.3% type IIIb, and 10% type IIIc. Fixation was 56.7% plate and screw, 20% intramedullary nail, and 16.7% external fixator. Definitive closure was achieved in 43.3% through local rotational flap (38.5% gastrocnemius, 61.5% soleus), and in 56.7% by free tissue transfer (29.4% latissimus, 23.5% rectus, 17.6% ALT, 17.6% gracilis). In 10 patients, 70% returned to full ambulation, 30% required an assistance device, and 50% achieved union in 6 months. Local flap use was predictive of ambulation at discharge. Following lower extremity fracture, 70% of patients returned to pre-injury function. Use of a local tissue flap was associated with early ambulation.
Sections du résumé
BACKGROUND
BACKGROUND
Lower extremity trauma accounts for over 300,000 injuries annually. While soft tissue transfer is a well-accepted practice for open fracture coverage, functional outcomes remain unclear.
HYPOTHESIS
OBJECTIVE
This study investigates functional outcomes following soft tissue reconstruction for open tibial fractures.
MATERIALS AND METHODS
METHODS
A retrospective review of a prospectively maintained database of open tibia fractures requiring soft tissue reconstruction was performed at an urban level 1 trauma center between October 2013 and March 2015.
OUTCOMES
RESULTS
were evaluated using Pearson's chi square test with significant p value < 0.05.
RESULTS
RESULTS
In 30 patients, fractures were graded Gustilo-Anderson type I (3.3%), 30% type II, 3.3% type IIIa, 53.3% type IIIb, and 10% type IIIc. Fixation was 56.7% plate and screw, 20% intramedullary nail, and 16.7% external fixator. Definitive closure was achieved in 43.3% through local rotational flap (38.5% gastrocnemius, 61.5% soleus), and in 56.7% by free tissue transfer (29.4% latissimus, 23.5% rectus, 17.6% ALT, 17.6% gracilis). In 10 patients, 70% returned to full ambulation, 30% required an assistance device, and 50% achieved union in 6 months. Local flap use was predictive of ambulation at discharge.
DISCUSSION
CONCLUSIONS
Following lower extremity fracture, 70% of patients returned to pre-injury function. Use of a local tissue flap was associated with early ambulation.
Identifiants
pubmed: 30705556
doi: 10.1016/j.jcot.2017.08.013
pii: S0976-5662(17)30408-3
pmc: PMC6349574
doi:
Types de publication
Journal Article
Langues
eng
Pagination
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