Ashford RU; Mehta, Janak; Cripps R

Author(s)

Ashford RU

Mehta, Janak

Cripps R

Publication Date

2004-04-01

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.

Affiliation

Department of Orthopaedic & Trauma Surgery, Royal Darwin Hospital, Casuarina NT0811, Australia. robert.ashford@virgin.net.

Citation

Injury 2004-04; 35(4): 411-6

ISSN

0020-1383

Pubmed ID

https://pubmed.ncbi.nlm.nih.gov/15037377/?otool=iaurydwlib

Link

https://hdl.handle.net/10137/5839

MESH subject

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

Title

Delayed presentation is no barrier to satisfactory outcome in the management of open tibial fractures.

Type of document

Journal Article

Entity Type

Publication

Author(s)	Ashford RU Mehta, Janak Cripps R
Publication Date	2004-04-01
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.
Affiliation	Department of Orthopaedic & Trauma Surgery, Royal Darwin Hospital, Casuarina NT0811, Australia. robert.ashford@virgin.net.
Citation	Injury 2004-04; 35(4): 411-6
ISSN	0020-1383
Pubmed ID	https://pubmed.ncbi.nlm.nih.gov/15037377/?otool=iaurydwlib
Link	https://hdl.handle.net/10137/5839
MESH subject	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
Title	Delayed presentation is no barrier to satisfactory outcome in the management of open tibial fractures.
Type of document	Journal Article
Entity Type	Publication

Delayed presentation is no barrier to satisfactory outcome in the management of open tibial fractures.

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