Background Open fractures associated with significant tissue loss are complex and present challenges in management; they are associated with poor outcomes such as infection, non-union or amputation. This study aimed to evaluate outcomes of using an adjuvant local antibiotic hydroxyapatite bio-composite in the management of open Gustilo-Anderson IIIB fractures with up to eight years of follow-up. Methods This was a retrospective study. A total of 81 patients with Gustilo-Anderson IIIB fractures treated with "fix and flap" limb reconstruction with adjuvant local antibiotic therapy using a bio-composite carrier were reviewed. Results The mean follow-up time for all the patients, at the time of data collection, was 55.8 months. Union was achieved in 96% with a limb salvage rate of 96.3% and a deep infection rate of 3.7%. Conclusion The use of local antibiotic therapy, together with a combined orthoplastic "fix and flap" approach for Gustilo-Anderson IIIB open fractures, was found to be associated with a very low rate of metalwork infection and high union and limb salvage rates. Future studies should include some functional and quality of life outcome measures to see the efficacy of this method.
Download full-text PDF |
Source |
---|---|
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC10270668 | PMC |
http://dx.doi.org/10.7759/cureus.39103 | DOI Listing |
J Orthop
February 2025
Department of Orthopaedics, University of KwaZulu Natal, South Africa.
Background: Osteogenic Bone Matrix (Altis™ OBM) is a tissue-engineered, porcine-derived demineralized bone matrix prepared using a humanization processing technology that confers biocompatibility and improved osteoinductivity. The objective of this study was to determine the safety and efficacy of OBM in patients with traumatic long bone defects in an open-label, non-randomized single-center study.
Methods: Diagnosis and main criteria for inclusion were open long bone fractures graded as Gustilo-Anderson Grade II, IIIA or IIIB.
JNMA J Nepal Med Assoc
April 2024
Nepal Medical College and Teaching Hospital, Jorpati, Kathmandu, Nepal.
Introduction: There is a high incidence of open fractures accounting 23% of all tibial fractures. The minimal soft tissue and precarious blood supply of the shaft of tibia make these fractures vulnerable to complications. The treatment should be decided through thoughtful analysis for personality of injuries and the status of the soft tissue.
View Article and Find Full Text PDFAnn Plast Surg
October 2024
Department of Plastic Reconstructive and Aesthetic Surgery, Sapienza Università di Roma, Rome.
Background: Open fractures of the lower limb represent a common challenge for trauma centers. Even where national guidelines are available, these standards are frequently missing. Our study evaluates the influence of polytrauma on the adherence to the timing and management required in an orthoplastic approach.
View Article and Find Full Text PDFJ Clin Orthop Trauma
August 2024
Orthopaedic Trauma Service, Santa Clara Valley Medical Center, USA.
Introduction: Despite modern approaches to open fracture management, fracture-related infection (FRI) rates remain high. Recent studies demonstrated the seasonal and regional variation of causative organisms in FRI. This study aims to better understand the causative organisms and identify preoperative risk factors for the primary outcome of FRIs at a Level I trauma center.
View Article and Find Full Text PDFInjury
November 2024
Department of Orthopaedics, R Adams Cowley Shock Trauma Center, University of Maryland School of Medicine, Baltimore, MD, United States. Electronic address:
Objective: To evaluate risk factors for infection in severe open tibial shaft fractures.
Methods: A secondary analysis of a multicenter prospective study investigated internal versus external fixation of severe open tibia fractures at 20 US Level I trauma centers. Adult patients, aged <65 years, with a Gustilo-Anderson Type IIIB or severe IIIA metaphyseal or diaphyseal tibia fracture were included.
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!