Ekstremite Açık Kırıklarında Komplikasyon ve Morbidite Oranları

Authors : Nadir Şener

Pages : 9-12

View : 44 | Download : 14

Publication Date : 2010-03-01

Article Type : Research

Abstract :Objectives: Type III A and B open fractures are prone to complications and reoperations because of soft tissue damage. We discussed our experience and problems on open extremity fractures. Patients and methods: Fourteen male and one female patient with type III A and B open fractures formed our study group. Their average age was 28.5 years. Injury type was industrial accident in 6 patients, traffi c accident in 6 patients, gunshot injury in 2 patients and falling down in 1 patient. Patients were arrived at our hospital in average 3.06 1-12 hours and operation was started in average 5.2 1-36 hours after they have arrived. Six of patients had type III A and nine of patients had type III B open fractures. Six patients had Tscherne grade I, six patients had grade II and 3 patients have grade III soft tissue damage. Primary operation was internal osteosynthesis in 8 patients and external fi xation in 7 patients. Soft tissue debridement, irrigation and triple antibiotheraphy were performed in all patients. Results: At a mean follow-up of 23.2 months, the rate of re-operation was 0.53. Infection was observed in 4 patients. In one patient below knee amputation was performed because of resistant osteomyelitis. Non-union occurred in 7 patients and delayed union occurred in 1 patient. Non-unions were treated with plate-screw in 3 patients, with Ilizarov frame in 2 patients, with intramedullary nail in 2 patients. Non-unions were not observed after re-operations. Patients with complications were in Tscherne grade II and III group. Eighty per cent of the patients returned to their previous work. Conclusion: Despite their high rate of non-union and complication, functional results of type III A and B fractures may be acceptable with early treatment and close follow-up. Most of the patients may return their previous work.
Keywords : fracture, osteosynthesis, non-union, complication, infection