Soft tissue management in open tibial shaft fractures: A comparison of institutional preferences and resultant early clinical outcomes

Bone & Joint Open
Matthew R GarnerJulie Agel

Abstract

To compare results of institutional preferences with regard to treatment of soft tissues in the setting of open tibial shaft fractures. We present a retrospective review of open tibial shaft fractures at two high-volume level 1 trauma centres with differing practices with regard to the acute management of soft tissues. Site 1 attempts acute primary closure, while site 2 prefers delayed closure/coverage. Comparisons include percentage of primary closure, number of surgical procedures until definitive closure, percentage requiring soft tissue coverage, and percentage of 90-day wound complication. Overall, there were 219 patients at site 1 and 282 patients at site 2. Differences in rates of acute wound closure were seen (168 (78%) at site 1 vs 101 (36%) at site 2). A mean of 1.5 procedures for definitive closure was seen at site 1 compared to 3.4 at site 2. No differences were seen in complication, nonunion, or amputation rates. Similar results were seen in a sub-analysis of type III injuries. Comparing outcomes of open tibial shaft fractures at two institutions with different rates initial wound management, no differences were seen in 90-day wound complications, nonunion rates, or need for amputation. Attempted acute closure resu...Continue Reading

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Citations

Dec 29, 2020·Bone & Joint Open·Fares S Haddad

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Methods Mentioned

BETA
amputation
amputations

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Medcalc
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