Negative pressure wound therapy for Gustilo Anderson grade IIIb open tibial fractures
| Autor: | Gi Beom Kim, Oog Jin Shon, Chul Hyun Park |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2016 |
| Předmět: |
musculoskeletal diseases
medicine.medical_specialty medicine.medical_treatment wound healing staged protocol mesh:wound infection Gustilo Anderson grade IIIb open fractures mesh:Tibial fractures 03 medical and health sciences External fixation 0302 clinical medicine lcsh:Orthopedic surgery Negative-pressure wound therapy medicine Orthopedics and Sports Medicine Tibia 030222 orthopedics negative pressure wound therapy business.industry Postoperative complication mesh:open fractures 030208 emergency & critical care medicine open fractures Surgery tibia MeSH terms: Tibial fractures lcsh:RD701-811 medicine.anatomical_structure Coronal plane Orthopedic surgery wound infection Original Article Ankle Range of motion business mesh:wound healing tibia |
| Zdroj: | Indian Journal of Orthopaedics Indian Journal of Orthopaedics, Vol 50, Iss 5, Pp 536-542 (2016) |
| ISSN: | 1998-3727 0019-5413 |
| Popis: | Background: Traditionally, Gustilo Anderson grade IIIb open tibial fractures have been treated by initial wide wound debridement, stabilization of fracture with external fixation, and delayed wound closure. The purpose of this study is to evaluate the clinical and radiological results of staged treatment using negative pressure wound therapy (NPWT) for Gustilo Anderson grade IIIb open tibial fractures. Materials and Methods: 15 patients with Gustilo Anderson grade IIIb open tibial fractures, treated using staged protocol by a single surgeon between January 2007 and December 2011 were reviewed in this retrospective study. The clinical results were assessed using a Puno scoring system for severe open fractures of the tibia at the last followup. The range of motion (ROM) of the knee and ankle joints and postoperative complication were evaluated at the last followup. The radiographic results were assessed using time to bone union, coronal and sagittal angulations and a shortening at the last followup. Results: The mean score of Puno scoring system was 87.4 (range 67–94). The mean ROM of the knee and ankle joints was 121.3° (range 90°–130°) and 37.7° (range 15°–50°), respectively. Bone union developed in all patients and the mean time to union was 25.3 weeks (range 16–42 weeks). The mean coronal angulation was 2.1° (range 0–4°) and sagittal was 2.7° (range 1–4°). The mean shortening was 4.1 mm (range 0–8 mm). Three patients had partial flap necrosis and 1 patient had total flap necrosis. There was no superficial and deep wound infection. Conclusion: Staged treatment using NPWT decreased the risks of infection and requirement of flap surgeries in Gustilo Anderson grade IIIb open tibial fractures. Therefore, staged treatment using NPWT could be a useful treatment option for Gustilo Anderson grade IIIb open tibial fractures. |
| Databáze: | OpenAIRE |
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