Please use this identifier to cite or link to this item: http://docs.prosentient.com.au/prosentientjspui/handle/1/11046
Title: Delayed presentation is no barrier to satisfactory outcome in the management of open tibial fractures.
Authors: Ashford, Robert U
Mehta, Janak A
Cripps, Robin
Affiliation: Department of Orthopaedic & Trauma Surgery, Royal Darwin Hospital, Casuarina NT0811, Australia. robert.ashford@virgin.net.
Issue Date: Apr-2004
Citation: Injury 2004-04; 35(4): 411-6
Abstract: The management of open tibial fractures is a challenge to all orthopaedic trauma surgeons. The major goals are fracture union, uncomplicated soft tissue healing and return to pre-injury level of function. The geographical isolation and vastness of the Northern Territory of Australia complicates the management of these injuries by adding a significant delay to treatment. Forty-five patients sustained 48 open tibial fractures over the 30-month period of the study. Twelve received primary surgical treatment within 6h of injury but 33 were treated more than 6h after injury. The mean time to treatment in this latter group was 12h 15min (median 9h 45min, range 6-37h). The majority of injuries were high energy, with 23 patients having multiple injuries and 29 fractures (60%) being classified as AO C3 with 35 (73%) having Gustilo III soft tissue injuries. There was a mean time to union of 7.5 months and an overall complication rate of 42.2%. Thirteen patients (29%) required additional (late) surgical procedures subsequent to definitive fracture and soft tissue management. The zone of injury infection rate was 12.5%. The high incidence of open tibial fractures places a large financial burden on the state. However, despite the absence of a plastic surgical service and delays in presentation, satisfactory outcomes can be obtained by the application of the established surgical principles of thorough debridement, soft tissue management and fracture stabilisation.
URI: http://docs.prosentient.com.au/prosentientjspui/handle/1/11046
DOI: 10.1016/S0020-1383(03)00236-5
ISSN: 0020-1383
Type: Journal Article
Subjects: Adolescent
Adult
Female
Fracture Fixation
Fractures, Open
Fractures, Ununited
Humans
Length of Stay
Male
Middle Aged
Retrospective Studies
Soft Tissue Injuries
Tibial Fractures
Time Factors
Treatment Outcome
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