Outcome of Open Long Bone Fractures in Dogs Stabilized with Linear External Skeletal Fixator

Background: External skeletal fixator (ESF) has been recommended as biological method to stabilize open fracture as it does not involves the wound site, besides protecting adjacent soft tissue structures. Considering the advantages of ESF, this study was envisaged with an objective to study the outcome of open fractures of radius-ulna and tibia-fibula stabilized with linear ESF in dogs.Methods: This study included 17 dogs suffering from open long bone fractures of radius-ulna and tibia-fibula, divided into three groups; linear ESF type I or II (group I, n=8) and type III (group II, n=3). In group III (n=6), open fractures were initially treated using conservative methods i.e management of open wound till complete healing followed by delayed internal fixation using intramedullary pin or bone plating.Result: Majority of the open fractures of radius-ulna and tibia-fibula were transverse (64.71%), involving distal third diaphysis (47.06%) in heavy weight (54.55%), 1-3 year old (64.71%), non-descript (35.29%), male (88.23%) dogs due to automobile accidents (58.82%). Neutrophilic (81.47±4.45%) leukocytosis (24610±2461.88 per cumm) and elevated levels of alkaline phosphatase and creatine kinase were observed. Staphylococcus spp. was the common isolated bacteria sensitive to Gentamicin, Cefotaxime, Tobramycin, Amikacin and Neomycin. High per cent fractures (83.33%) in group III had acceptable functional outcome as compared to fractures treated with linear ESF (55.55%) in groups I and II. Osteomyelitis due to pin tract infections was the major complication (8/11; 72.7%) recorded in ESF groups (Group I and II) that lead to delayed and/or nonunion. Weight bearing score improved markedly after removal of the ESF frame. In conclusions, immediate fixation of the long bone fracture using linear ESF in the presence of open contaminated / infected wounds leads to unacceptable outcome. Poor animal compliance, pin tract discharge, osteomyelitis, delayed union and nonunion are major complications associated with linear ESF. Conservative management of the open fracture wound using standard treatment for 2-3 weeks till complete wound healing followed by internal fixation with intramedullary pin or bone plate is recommended for open long bone fractures in dogs.

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A prospective study on results of bacterial culture from wound in type III compound fractures

International Journal of Research in Orthopaedics ◽

10.18203/issn.2455-4510.intjresorthop20184389 ◽

2018 ◽

Vol 4 (6) ◽

pp. 935

Author(s):

Ashwin H. ◽

George Thomas

Keyword(s):

Staphylococcus Aureus ◽

Prospective Study ◽

Antimicrobial Susceptibility ◽

Open Fracture ◽

Bone Fractures ◽

Open Fractures ◽

Long Bone ◽

Type Iii ◽

Long Bone Fractures ◽

A Prospective Study

Background: Open fractures still represent a major challenge for the treating surgeon. Sound knowledge of the bacteriological epidemiology and antimicrobial susceptibility helps to prevent complications. Our aim is to study about the common bacteria causing open fracture infection and their antibiotic sensitivity in patients who are admitted in the department of Orthopedics, Government medical college, Kottayam.Methods: A prospective study on 130 patients with type III open long bone fractures were studied for infection during study period of June 2016 to July 2017. After initial debridement and at third day during follow up wound inspection, swabs were taken from wound site. Swabs were send for microscopic examination, culture and antimicrobial susceptibility testing.Results: Out of 130 type III open long bone fractures, 7.7% were having day 0 infection and 25.4% were having day 3 infection. 19.2% of patients developed infection from day 3 onwards. Staphylococcus aureus (37.1%) was the most commonly isolated bacteria from wound. Other organisms isolated were Acinetobacter, Pseudomonas, Klebsiella, E coli, Enterococcus, Streptococcus and Enterobacter. 100% of diabetic patients developed infection on day 3. Gentamicin, amikacin doxycycline, ciprofloxacin, vancomycin, piperacillin + tazobactum and cefoperazone + sulbactum were found to be effective against isolated organisms.Conclusions: Gram positive Staphylococcus aureus was found to be the most common cause of wound infection in type III open fractures. An early adequate wound debridement, proper antibiotic therapy and aseptic post-operative wound care are essential for wound healing and fracture union in an open fracture.

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Internal fixation: An evolutionary appraisal of methods used for long bone fractures

International Journal of Biomedical and Advance Research ◽

10.7439/ijbar.v5i3.627 ◽

2014 ◽

Vol 5 (3) ◽

pp. 142 ◽

Cited By ~ 1

Author(s):

Seemab Mehmood ◽

Umar Ansari ◽

Murtaza Najabat Ali ◽

Nosheen Fatima Rana

Keyword(s):

Internal Fixation ◽

Bone Fractures ◽

Long Bone ◽

Long Bone Fractures

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Treatment of Long Bone Fractures in Calves with Ilizarov External Fixator

Veterinary and Comparative Orthopaedics and Traumatology ◽

10.1055/s-0038-1667147 ◽

2018 ◽

Vol 31 (05) ◽

pp. 364-372

Author(s):

Murat Sarierler ◽

Ali Gülaydin

Keyword(s):

External Fixator ◽

Bone Fractures ◽

Long Bone ◽

Ilizarov External Fixator ◽

Injured Limb ◽

Radiographic Findings ◽

Advantages And Disadvantages ◽

The Third ◽

Long Bone Fractures ◽

Tract Infections

In this study, the advantages and disadvantages of Ilizarov external fixator in the treatment of long bone fractures in calves were investigated. For this purpose, 26 calves of different breeds, ages and genders, having metacarpal (n = 12), metatarsal (n = 5) and antebrachial (n = 9) fractures underwent surgery under general anaesthesia. Frames, which were prepared before surgery in accordance with the radiographic findings, were applied under open reduction in 18 cases, and under closed reduction in eight cases. In the postoperative period, all calves except one started to bear some weigh on the injured limb on the first day, while the remaining calf did the same on the second day. The consolidation started in the first 2 weeks for 24 of the calves and was completed by the day 55. In the two remaining cases, it started in the third week and was completed on day 71 and day 90, respectively.The soft tissue wounds were completely healed in all calves and no complications occurred. In five calves that were not kept in our clinic pin tract infections formed. They were controlled rapidly, and there was no change in the fracture reduction or healing duration.In conclusion, in our study, the Ilizarov external fixator system was applied to long bone fractures in cattle calves, in cases where the fragments were not large enough to apply pins and plates, and which became open and infected after defective bandage practices or unsuitable treatment. Fractures completely healed in all cases, without any complications. These results show that many of the long bone fractures experienced by calves, that were considered for amputation due to the anticipated inability to treat them successfully, could be treated with the use of the Ilizarov system.

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Internal Fixation of Long Bone Fractures in Farm Animals

Veterinary and Comparative Orthopaedics and Traumatology ◽

10.1055/s-0038-1633144 ◽

1993 ◽

Vol 06 (01) ◽

pp. 36-41 ◽

Cited By ~ 13

Author(s):

A. Steiner ◽

U. Iselin ◽

C. Lischer ◽

J. A. Auer

Keyword(s):

Internal Fixation ◽

Bone Fracture ◽

Bone Fractures ◽

Farm Animals ◽

Long Bone ◽

Fracture Treatment ◽

Long Bone Fractures ◽

Long Bone Fracture

This study demonstrates that long bone fracture treatment in food and fibre producing animals is in most cases successful. The greatest disadvantage of such treatment are the costs of the surgery and implants.

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Prophylactic Topical Gentamicin after Open Reduction and Internal Fixation of Long Bone Fractures in Orthopedics

Journal of Applied Sciences ◽

10.3923/jas.2008.3753.3756 ◽

2008 ◽

Vol 8 (20) ◽

pp. 3753-3756 ◽

Cited By ~ 2

Author(s):

A. Zyaie ◽

Dr. A.R. Saied

Keyword(s):

Internal Fixation ◽

Open Reduction ◽

Bone Fractures ◽

Long Bone ◽

Long Bone Fractures

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DOES THE TERM OF DEFINITIVE OSTEOSYNTHESIS OF MULTIPLE LONG BONE FRACTURES OF LOWER EXTREMITIES IMPACT ON TREATMENT OUTCOMES IN POLYTRAUMA PATIENTS

EUREKA Health Sciences ◽

10.21303/2504-5679.2020.001332 ◽

2020 ◽

Vol 4 ◽

pp. 24-31

Author(s):

Olexandr Burianov ◽

Sergii Dubrov ◽

Taras Omelchenko ◽

Volodymyr Lianskorunskyi ◽

Viktor Lykhodii ◽

...

Keyword(s):

Length Of Stay ◽

Bone Fractures ◽

Damage Control ◽

Lower Extremities ◽

Hospital Length Of Stay ◽

Long Bone ◽

Long Bone Fractures ◽

Group I ◽

Fracture Osteosynthesis ◽

Group Ii

The aim: to determine the timing impact of definitive multiple long bone fracture osteosynthesis of lower extremities on complications development, duration of Mechanical Ventilation (MV), Length of Stay in Intensive Care Unit (LOS-ICU), Hospital length of Stay (H-LOS) in patients with polytrauma treated according to Damage Control Orthopedics (DCO). Materials and methods: a prospective controlled non-randomized trial in parallel groups conducted in polytrauma department of Kyiv City Clinical Hospital No. 17 from February 2016 to January 2020, which included 107 adult patients with polytrauma, multiple long bone fractures of lower extremities, one of which femur treated according to DCO. The patients were divided into two groups: Group I included 51 patients who underwent definitive osteosynthesis of long bone fractures of lower extremities after patient condition stabilization ≥24 hours ≤5 days; Group II included 56 patients who underwent definitive osteosynthesis of long bone fractures of lower extremities during the period >5 days after injury. Results: there were no statistically significant differences between Group I and Group II patients in demographics, injury mechanism, trauma severity and general patient condition. Group I patients who underwent osteosynthesis from 2nd to 5th days after injury had lower pneumonia incidence, compared to Group II patients (17.6 % vs. 26.8 %, p=0.047), shorter MV duration (9.3±6.9 vs. 14.9±9.1, p=0.048), ICU-LOS (13.5±8.3 vs. 19.1±11.0, p=0.037), and H-LOS (30.3±13.9 vs. 38.9±15.5, p=0.046). Conclusion: performing definitive multiple fracture osteosynthesis of lower extremity long bones after polytrauma patient stabilization from 2nd to 5th days after injury allowed to reduce the frequency of pneumonia, shorten the duration of MV, LOS-ICU and H-LOS, compared with its implementation after 5th days

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Local Platelet-rich plasma (PRP) injection for the treatment of Delayed Union after Internal Fixation in Fractures of Long Bones

Journal of Society of Surgeons of Nepal ◽

10.3126/jssn.v23i1.33523 ◽

2020 ◽

Vol 23 (1) ◽

pp. 30-36

Author(s):

Tanup Prasai ◽

Sashmit Sharma ◽

Kiran Prasad Rijal ◽

Krishna Raj Khanal

Keyword(s):

Internal Fixation ◽

Bone Fractures ◽

Platelet Rich Plasma ◽

Delayed Union ◽

Long Bone ◽

Non Union ◽

Medical College ◽

Long Bone Fractures ◽

Usual Solution ◽

Without Bone Graft

Introduction: Long bone fractures are among the most common orthopaedic injuries encountered. A fracture that fails to progress to union despite appropriate fixation and absence of complications presents a treatment dilemma to the surgeon. The usual solution of re-fixation with or without bone graft constitutes repeat exposure to surgery and its risks, as well as added morbidity and cost. Recent advances in molecular biology suggest Platelet rich plasma (PRP) may have bone forming potential. This study was done to determine whether PRP has any beneficial role in patients with delayed healing of long bone fractures. Methods: A prospective interventional study was done on patients arriving at the department of orthopaedic surgery of Kathmandu Medical College with delayed union of long bone fractures after internal fixation between January 2014 and January 2017. Patients were treated with local injection of group-matched PRP directly into the fracture gap and were followed-up for six months to check for radiological signs of fracture union. Results: A total of 10 fractures were included in 10 patients that involved four humeri, three tibiae, and three femora. Eight out of the 10 fractures united at a median time of three months after the injection. Two had non-union that required revision surgery. Conclusion: Local Platelet rich plasma injection may constitute a ‘nothing to lose, everything to gain’ intermediate option before a decision for major reoperation on such patients is made.

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