Vascular injuries in compound fractures of the leg with initially adequate circulation

The Journal of Bone and Joint Surgery. British Volume
S WaikakulV Vanadurongwan

Abstract

We carried out a randomised, controlled trial in 157 patients who had isolated severe Gustilo type-IIIa and type-IIIb fractures of the metaphysis or diaphysis of the leg to determine the prevalence of vascular injuries and the role of vascular repair. All patients had stable vital signs and clinically adequate circulation in their legs before operation. In a control group of 64 patients we performed conventional surgery with systematic debridement and primary stabilisation of the fractures. In the trial group of 93 patients the major vessels and nerves adjoining the compound fracture were routinely explored and repaired when necessary after the initial procedure. Two of the 28 control patients (7.1%) with type-IIIb compound fractures had signs of inadequate circulation after the first operation. Both had major vascular injuries which were demonstrated at a second procedure. In the trial group, major vascular injuries were found in two of 54 patients (3.7%) with type-IIIa and 11 of 39 patients (28.2%) with type-IIIb compound fractures. Compared with the control group the trial group showed improved results at both the immediate and long-term follow-up. Routine exploration and early repair of injured major vessels of the leg in s...Continue Reading

Citations

Oct 16, 2002·Injury·Alejandro GuerreroRiyad Karmy-Jones
Aug 25, 2011·Injury·Umraz KhanTimothy J S Chesser
Feb 10, 2009·Journal of Plastic, Reconstructive & Aesthetic Surgery : JPRAS·G E GlassJ Nanchahal
Feb 4, 2010·Journal of the American College of Surgeons·Nicholas T HaddockPierre B Saadeh
Jun 9, 2016·European Journal of Trauma and Emergency Surgery : Official Publication of the European Trauma Society·O TunaliO Yazicioglu
Mar 14, 2019·European Journal of Orthopaedic Surgery & Traumatology : Orthopédie Traumatologie·O O'MalleyC B Hing
Sep 9, 2005·The Journal of the American Academy of Orthopaedic Surgeons·Rakesh P MashruPeter D Pizzutillo
Oct 19, 2012·Plastic and Reconstructive Surgery·Shaheel ChummunUmraz Khan
Dec 22, 2020·World Journal of Clinical Cases·Ting ZhuShun-Sheng Zhang

❮ Previous
Next ❯

Related Concepts

Trending Feeds

COVID-19

Coronaviruses encompass a large family of viruses that cause the common cold as well as more serious diseases, such as the ongoing outbreak of coronavirus disease 2019 (COVID-19; formally known as 2019-nCoV). Coronaviruses can spread from animals to humans; symptoms include fever, cough, shortness of breath, and breathing difficulties; in more severe cases, infection can lead to death. This feed covers recent research on COVID-19.

Blastomycosis

Blastomycosis fungal infections spread through inhaling Blastomyces dermatitidis spores. Discover the latest research on blastomycosis fungal infections here.

Nuclear Pore Complex in ALS/FTD

Alterations in nucleocytoplasmic transport, controlled by the nuclear pore complex, may be involved in the pathomechanism underlying multiple neurodegenerative diseases including Amyotrophic Lateral Sclerosis and Frontotemporal Dementia. Here is the latest research on the nuclear pore complex in ALS and FTD.

Applications of Molecular Barcoding

The concept of molecular barcoding is that each original DNA or RNA molecule is attached to a unique sequence barcode. Sequence reads having different barcodes represent different original molecules, while sequence reads having the same barcode are results of PCR duplication from one original molecule. Discover the latest research on molecular barcoding here.

Chronic Fatigue Syndrome

Chronic fatigue syndrome is a disease characterized by unexplained disabling fatigue; the pathology of which is incompletely understood. Discover the latest research on chronic fatigue syndrome here.

Evolution of Pluripotency

Pluripotency refers to the ability of a cell to develop into three primary germ cell layers of the embryo. This feed focuses on the mechanisms that underlie the evolution of pluripotency. Here is the latest research.

Position Effect Variegation

Position Effect Variagation occurs when a gene is inactivated due to its positioning near heterochromatic regions within a chromosome. Discover the latest research on Position Effect Variagation here.

STING Receptor Agonists

Stimulator of IFN genes (STING) are a group of transmembrane proteins that are involved in the induction of type I interferon that is important in the innate immune response. The stimulation of STING has been an active area of research in the treatment of cancer and infectious diseases. Here is the latest research on STING receptor agonists.

Microbicide

Microbicides are products that can be applied to vaginal or rectal mucosal surfaces with the goal of preventing, or at least significantly reducing, the transmission of sexually transmitted infections. Here is the latest research on microbicides.

Related Papers

The Journal of Bone and Joint Surgery. British Volume
P A OstermannS L Henry
Journal of the American Podiatric Medical Association
Deepak JoshiYadu Lal
Plastic and Reconstructive Surgery
Shaheel ChummunUmraz Khan
© 2022 Meta ULC. All rights reserved