The results of 39 fractures complicated by major segmental bone loss and/or leg length discrepancy
| Autor: | William M. Swartz, Dana C. Mears, Gregg L. Goldstrohm |
|---|---|
| Rok vydání: | 1984 |
| Předmět: |
Adult
Male Open fracture medicine.medical_specialty Adolescent medicine.medical_treatment Nonunion Critical Care and Intensive Care Medicine Iliac crest Fracture Fixation Internal Fractures Bone Bone Lengthening Fracture Fixation medicine Humans Limb length discrepancy Child Aged Retrospective Studies Debridement Bone Transplantation business.industry Leg length Middle Aged medicine.disease Surgery Leg Length Inequality medicine.anatomical_structure Amputation Child Preschool Fractures Ununited Wound Infection Female business Cancellous bone |
| Zdroj: | The Journal of trauma. 24(1) |
| ISSN: | 0022-5282 |
| Popis: | Thirty-nine fractures with segmental bone loss and/or limb length discrepancy with defects of 1.8 to 12.0 cm were reviewed retrospectively. Most patients presented with an acute open fracture with segmental bone loss or a late reconstructive problem with a nonunion, frequently complicated by infection, segmental bone loss, and adjacent soft-tissue disruption. One hundred forty-two weeks was the average length of time of treatment before referral of a patient to us. Eighty-eight per cent of the patients received a bone graft that included either autologous cancellous bone, bank bone, a vascularized free iliac crest or fibular transplant, or some combination of these materials. Forty per cent of the patients required some type of soft-tissue coverage such as a split-thickness skin graft, myoplasty, or a free vascularized flap. Seventy-nine per cent of the cases achieved complete osseous and soft-tissue healing within an average of 49 weeks. One patient underwent an above-knee amputation. Almost 80% of all of the patients healed to within 85% or better of anatomic length. Based upon these results a protocol for the management of osseous and soft-tissue defects is outlined which includes debridement, rigid stabilization, and various types of soft-tissue and osseous reconstruction. |
| Databáze: | OpenAIRE |
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