Staged Management of High Energy Proximal Tibia Fractures with Severe Soft Tissue Damage

2009 ◽  
Vol 22 (3) ◽  
pp. 152
Author(s):  
Seung-Ryul Lee ◽  
Jae-Hoon Yang ◽  
June-Kyu Lee ◽  
Hyun-Dae Shin ◽  
Kyung-Cheon Kim ◽  
...  
Author(s):  
Aftab Alam Khanzada ◽  
Muhammad Rafique Joyo ◽  
Muhammad Imran Javed ◽  
Nizam Ahmed ◽  
Niaz Hussain Keerio ◽  
...  

Background: Significant articular depression, separation of both condyles, diaphyseal comminution and dissociation, and loss of soft-tissue envelope integrity are all associated with high-energy proximal tibia fractures (Schatzker VI). Over the past 50 years, there has been a lot of research on plating problems in these complicated fractures. For the care of these complex injuries, Ilizarov devised a new method (ring fixator). Aim of the Study: To examine the outcomes of patients who received a ring fixator for the treatment of high-energy proximal tibia fractures (Schatzker VI). Materials and Methods: Fourteen patients (mean age 36) were treated with the Ilizarov fixator and transfixion wires for high-energy fractures of the proximal tibia (Schatzker VI). Nine of the patients had open fractures, and five of them had significant soft tissue damage. They were all tracked for an average of 19.4 months. The result was analyzed using the criteria set by Honkonen & Jarvinen (1992). Results: Thirteen fractures healed in an average of 14.6 weeks, with one taking six months. Twelve patients recovered complete extension, while eight others regained more than 110 degrees of flexion. All of the patients knees were stable, except one who had a minor varus deformity. Nine patients walked normally, while four had a little limp. Except for one, all of the knees exhibited an articular step-off of less than 4 mm and normal axial alignment. Six knees were found to be outstanding, five to be decent, and three to be fair. There were no instances of postoperative skin infection or septic arthritis, however, three patients did have a pin tract infection that was effectively managed. Conclusion: The technique is suitable for the treatment of complex proximal tibia fractures when there is substantial comminution at the fracture site as well as soft tissue damage (Schatzker VI).


2021 ◽  
pp. 66-70
Author(s):  
Nirjhar Maji ◽  
Anurag Das ◽  
Kuntal Bakuli

Background and objectives: High energy proximal tibia fractures (OTA 41/Schatzker 4/5/6) are common in motorbike accidents even in semi urban and sub-urban areas. Recommended management involves two stages with conventional Mantra of 'Span-Scan-Plan'. First stage involves temporary knee spanning external xator to prevent or manage impending compartment syndrome. This is followed by CTScan. The second stage is the denitive internal xation. These recommendations are not universally followed due to certain infrastructural and acceptability constraints inuencing decision making. Summary: The study is designed as prospective observational study. It is conducted in a District Hospital setup. An effort to dene and recognise “Impending Compartment Syndrome” is made by developing a clinical criteria based evaluation score. This score was used to monitor fracture related soft tissue changes over the initial period until denitive xation. All patients underwent temporary stabilisation by different methods. These different temporary xation methods were compared amongst each other to nd out their efcacy. Patient was assessed to the end point of where soft tissues settled down for denitive xation. Surgical site infection and knee function was assessed to nd out whether the type of temporary xation had any subsequent on soft tissue and knee joint. The results were statistically analysed to nd out clinical signicance.


2007 ◽  
Vol 22 (2) ◽  
pp. 106-108 ◽  
Author(s):  
Hazem M. Hamouda ◽  
Eivind Witsø ◽  
Nedal K.E. Moghani ◽  
Ahmed Shahwan ◽  
Øystein P. Nygaard

AbstractIntroduction:Patients with soft tissue injuries caused by missile attacks during wartime have been treated with radical debridement and delayed closure. In a study in Gaza City, the rate of infection of missile injuries to the extremities when treated with minimal surgical intervention, was measured.Methods:Patients with severe soft tissue damage, compound fractures, and injuries to major blood vessels and/or nerves were excluded from the study. One hundred fourteen patients were treated according to a standardized regime that included a superficial, minor surgery revision of the inlet and the outlet opening, and antibiotic treatment. Local soft tissue infection was defined as the presence of at least two signs of local infection.Results:A total of 109 out of 114 patients attended the first follow-up visit. Eleven (10%) of these patients had an infected wound. A total of 105 of the patients (92%) attended a second follow-up. None of these patients had an infected wound.Conclusions:Under conditions with a high number of causalities, minimal surgical treatment followed by the administration of antibiotics is a safe procedure for patients with penetrating missile injuries and less severe soft tissue damage.


2005 ◽  
Vol 19 (7) ◽  
pp. 448-455 ◽  
Author(s):  
Kenneth A Egol ◽  
Nirmal C Tejwani ◽  
Edward L Capla ◽  
Philip L Wolinsky ◽  
Kenneth J Koval

2020 ◽  
Vol 30 (4) ◽  
pp. 671-680 ◽  
Author(s):  
Gianluca Canton ◽  
Federico Santolini ◽  
Marco Stella ◽  
Antonio Moretti ◽  
Michele Francesco Surace ◽  
...  

Sign in / Sign up

Export Citation Format

Share Document