Operative Treatment and Soft Tissue Management of Open Distal Tibial Fractures - Pitfalls and Results

European Journal of Trauma and Emergency Surgery : Official Publication of the European Trauma Society
Maximilian FaschingbauerBenjamin Kienast

Abstract

Open tibial fractures usually result from high-energy trauma. Severe soft-tissue injuries are often combined with open fractures of the distal tibia. A consecutive series of 42 patients with open extraarticular distal tibial fractures (Gustilo I-IIIc) operated on between July 2006 and February 2009 were included in the study reported here. We performed open reduction and internal fixation for the Gustilo I cases. Soft tissue was closed directly after antibiotic beads had been temporarily applied. For the Gustilo II and III cases, our treatment protocol included soft-tissue debridement of all devitalized soft tissue and bone fragments, pulsatile jet irrigation, and external stabilization. Soft tissue was temporarily closed with Epigard_ after the application of antibiotic beads. A second-look operation was scheduled after 3-5 days. Gustilo II patients needed an average of 1.1 (0-3) revisions until wound closure, compared to the average of 2.1 revisions necessary for the Gustilo III patients. It took 5.6 (0-16) days to obtain definitive wound closure in the Gustilo II patients and 9.9 (3-28) days in the Gustilo III patients. Skin grafting was sufficient for definitive softtissue closure in ten cases, local flaps in eight cases, a...Continue Reading

References

Jan 1, 1990·The Journal of Bone and Joint Surgery. British Volume·G G RussellG Arnett
Nov 1, 1985·Plastic and Reconstructive Surgery·H S ByrdG Cierney
Jun 1, 1996·Clinical Orthopaedics and Related Research·L S Levin, D P Condit
Apr 8, 1999·Injury·C M Court-BrownM M McQueen
Oct 21, 2000·The Journal of Bone and Joint Surgery. British Volume·S GopalR M Smith
Dec 10, 2002·The Journal of the American Academy of Orthopaedic Surgeons·Amanda D Weitz-Marshall, Michael J Bosse
Feb 13, 2003·The Journal of Trauma·Christoph Heitmann, L Scott Levin
Sep 1, 2006·Archives of Orthopaedic and Trauma Surgery·E HohmannT F Wiesniewski
Feb 20, 2007·Injury·Charles M Court-Brown, Alistair Brydone
Mar 20, 2008·Plastic and Reconstructive Surgery·Timothy BhattacharyyaBohdan Pomahac
Sep 23, 2008·Injury·Yuan-Kun TuRyosuke Kakinoki
Oct 30, 2008·Der Unfallchirurg·G Streicher, H Reilmann
Feb 5, 2009·The Journal of Bone and Joint Surgery. British Volume·S RajasekaranS R Sabapathy

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Citations

Dec 1, 2009·European Journal of Trauma and Emergency Surgery : Official Publication of the European Trauma Society
Feb 11, 2018·European Journal of Orthopaedic Surgery & Traumatology : Orthopédie Traumatologie·Michael SchlumbergerTobias Roth

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