scholarly journals A PROSPECTIVE ANALYSIS OF OUTCOME IN CONVERSION OF EXTERNAL FIXATORS TO INTERNAL FIXATORS IN OPEN FRACTURES OF LOWER LIMBS

2018 ◽  
Vol 04 (10) ◽  
Author(s):  
Dr. L. Prasanna Kumar ◽  
Keyword(s):  
Open Fractures ◽  
Lower Limbs ◽  
External Fixators ◽  
Prospective Analysis ◽  
Internal Fixators

Preventing Air Leakage in Negative Atmospheric Pressure Therapy for Open Fractures Treated With External Fixators

2013 ◽  
Vol 38 (12) ◽  
pp. 2520 ◽  
Author(s):  
İlhami Oğuzhan Aydoğdu ◽  
Engin Yosma ◽  
Tekin Şímşek ◽  
Musa Kemal Keleş
Keyword(s):  
Atmospheric Pressure ◽  
Open Fractures ◽  
External Fixators ◽  
Air Leakage ◽  
Pressure Therapy

Flexible Fixation and Fracture Healing: Do Locked Plating ‘Internal Fixators’ Resemble External Fixators?

2011 ◽  
Vol 25 ◽  
pp. S15-S20 ◽  
Author(s):  
Hagen Schmal ◽  
Peter C Strohm ◽  
Martin Jaeger ◽  
Norbert P Südkamp
Keyword(s):  
Fracture Healing ◽  
External Fixators ◽  
Internal Fixators ◽  
Locked Plating

scholarly journals Prevalence and Pattern of Open Fractures in Level-II Hospital, Central Africa

2021 ◽  
Vol 16 (1) ◽  
pp. 50-53
Author(s):  
Suman Kumar Sen ◽  
Susmita Debnath ◽  
Md Maksudul Haque
Keyword(s):  
Motor Vehicle ◽  
Road Traffic ◽  
Central Africa ◽  
Open Fractures ◽  
Lower Limbs ◽  
Trauma Patients ◽  
Risk Of Infection ◽  
Level Ii ◽  
Gun Shot ◽  
Shot Wounds

Introduction: Open fractures are known orthopaedic emergencies associated with healing problems and risk of infection. The open fractures are common cases because of motor vehicle and motorbike accidents, falls from height and sometimes gun-shot wounds. Significant morbidity and subsequent disability may happen, if not managed properly. Aim: To evaluate the pattern of open fractures associated with healing problems and achieving sound bone union, avoiding infection and regaining full functional recovery of the limb. Methods: This retrospective study included all the patients who were hospitalized with open fractures of lower limbs in a United Nations Level II Hospital of Bangladesh Medical Contingent at Kaga-Bandoro in Central African Republic from April 2015 to November 2018. Results: There were 57 patients with open fractures resulting 17.8% of total trauma patients. The mean age was 31.8±11.6 years. Most patients were in the 20-39 years age group. The male to female sex ratio was 4.2:1. Road traffic accident was the main cause of open fractures (59.6%). Fractures of tibia-fibula and femur contributed 49.1% and 15.7% respectively and 89.4% satisfactory results were achieved after treatment. Conclusion: The management of open fractures presents a challenge due to risk of infection, healing problems and subsequent morbidity. Adequate debridement and copious lavage remains one of the cornerstones of management of open fractures. The initial management of open fractures affects the ultimate outcome. JAFMC Bangladesh. Vol 15, No 1 (June) 2020: 50-53

scholarly journals Norwegian Open Fracture Management System: Outcomes After 10 Years Working in Low-Resource Settings in Cambodian Hospitals

2022 ◽  
pp. 1-11
Author(s):  
Nenad B. Tajsic ◽  
Sigrunn H. Sørbye ◽  
Sophy Nguon ◽  
Vannara Sokh ◽  
Aymeric Lim
Keyword(s):  
Limb Salvage ◽  
Management System ◽  
Open Fracture ◽  
Lower Limbs ◽  
Limb Salvage Surgery ◽  
External Fixators ◽  
Soft Tissue Reconstruction ◽  
Low Resource Settings ◽  
Low Resource ◽  
Fracture Management

Abstract Introduction: The treatment of open lower limb fractures represents a major challenge for any trauma surgeon, and this even more so in resource-limited areas. The aim of the study is to describe the intervention, report the treatment plan, and observe the effectiveness of the Norwegian Open Fracture Management System in saving lower limbs in rural settings. Materials and Methods: A retrospective and prospective interventional study was carried out in the period 2011 through 2017 in six rural hospitals in Cambodia. The fractures were managed with locally produced external fixators and orthosis developed in 2007. Based on skills and living locations, two local surgeons and one paramedic without reconstructive surgery experience were selected to reach the top of the reconstructive ladder and perform limb salvage surgeries. This study evaluated 56 fractures using the Ganga Hospital Open Injury Score (GHOIS) for Gustilo-Anderson Type IIIA and Type IIIB open fracture classification groups. Results: The primary success rate in open tibia fractures was 64.3% (95% CI, 50.3 - 76.3). The average treatment time to complete healing for all of the patients was 39.6 weeks (95% CI, 34.8 - 44.4). A percentage of 23.2% (95% CI, 13.4 - 36.7) experienced a deep infection. Fifteen of the patients had to undergo soft tissue reconstruction and 22 flaps were performed. Due to non-union, a total of 15 bone grafts were performed. All of the 56 patients in the study gained limb salvage and went back to work. Conclusion: The given fracture management program proves that low-resource countries are able to produce essential surgical tools at high quality and low price. Treatment with external fixation and functional bracing, combined with high-level training of local surgeons, demonstrates that a skilled surgical team can perform advanced limb salvage surgery in low-resource settings.

scholarly journals Prophylactic use of antibiotic laden poly methyl methacrylate beads in the management of open fractures: a novel approach for control of orthopaedic infection

2019 ◽  
Vol 5 (4) ◽  
pp. 624
Author(s):  
Hariprasad Seenappa ◽  
Prabhulingreddy Patil ◽  
Harsha Madamanchi ◽  
Sakthikesavan Sivanandan
Keyword(s):  
Methyl Methacrylate ◽  
Standard Care ◽  
Financial Burden ◽  
Open Fractures ◽  
External Fixators ◽  
Poly Methyl Methacrylate ◽  
Novel Approach ◽  
Group A ◽  
Prophylactic Use ◽  
Group B

<p class="abstract"><strong>Background:</strong> Control of infection in open fractures is a challenge in orthopaedic surgery. The literature provides evidence that antibiotic-laden bead chains are a useful adjuvant with systemic antibiotics in the prevention of infection in open fractures.</p><p class="abstract"><strong>Methods:</strong> Between February 2018 and January 2019, sixty four patients with open type fractures admitted in emergency room were analysed for this study. In this 64 patients, 32 in Group A received antibiotic laden PMMA (Poly methyl methacrylate) beads with standard care. Another 32 in Group B received standard care.<strong></strong></p><p class="abstract"><strong>Results:</strong> There were 54 males and 10 females with a mean age of 41 and follow up 6 months. Among 64 patients 37 patients were stabilised with external fixators and remaining 17 patients underwent a definitive fixation either an intramedullary nailing (12 patients) or internal fixation with a plate (5 patients). 10 patients were stabilised with k wires. The infection rate in group A and B was 6.25% and 21.8% respectively which is statistically not significant (p=0.072).</p><p class="abstract"><strong>Conclusions:</strong> Although the final infection control rate was comparable between the bead group (30/32, 93.75%) and the non bead group (25/32, 78.12%), few complications were noted in the bead group (9.37%, 3/32) than in the group B (15.62%, 5/32). Hence the prophylactic use of antibiotic cement beads is advantageous in preventing post traumatic orthopaedic infection, lessens hospital stay as well the financial burden to the patients.</p>

scholarly journals Treatment of open tibia fractures in Sub-Saharan African countries : a systematic review

2021 ◽  
Vol 87 (1) ◽  
pp. 85-92
Author(s):  
Kouamé Jean-Eric Kouassi ◽  
Julie Manon ◽  
Loïc Fonkoue ◽  
Christine Detrembleur ◽  
Olivier Cornu
Keyword(s):  
Systematic Review ◽  
Operative Management ◽  
Open Fractures ◽  
Local Source ◽  
External Fixators ◽  
Cast Immobilization ◽  
African Countries ◽  
Increased Risk ◽  
Sub Saharan ◽  
Non Operative Management

Open tibia fracture (OTF) treatment is well documented in developed countries. Yet, this fracture pattern remains challenging because it is associated with an increased risk of infection and delayed union, particularly in case of Gustilo III B and C open fractures. Since access to healthcare is limited in Sub- Saharan African countries, this paper explores the results of OTF management in this setting. A systematic review of the literature was conducted using current databases such as MEDLINE, Cochrane, EMBASE, PubMed, ScienceDirect, Scopus, and Google Scholar in order to identify prospective studies with cohorts of patients treated for OTF. Studies were included based on predefined inclusion and exclusion criteria. The quality of studies was analyzed by the Coleman Methodology Score (CMS). Eight papers met the inclusion criteria and had an average CMS of 70 (range 54-73). The most common treatment was non-operative management of the fracture with cast immobilization (67%). Gustilo Type II and III fractures were associated with a higher risk of complications. The infection rate was 30%. Malunion, chronic osteomyelitis and nonunion were observed in 14.5%, 12.3%, and 7% of the cases, respectively. More complications were observed with non-operative treatment (cast immobilization) than with surgical fixation. Although the surgical environment does not allow for internal fixation, poor results of non-operative management of open fractures should lead to the introduction of trainings on the proper use of external fixators. It is also advisable to support the development of locally produced external devices that utilize local source materials, which would make external fixation available at a reasonable cost.

scholarly journals STUDY ON SPANNING EXTERNAL FIXATORS FOR PERIARTICULAR OPEN FRACTURES

2017 ◽  
Vol 4 (35) ◽  
pp. 2136-2138
Author(s):  
Prasanth Maddila ◽  
Anil Babu Patibandla
Keyword(s):  
Open Fractures ◽  
External Fixators

Validation of Feedback Control Approach for an Implantable Limb Lengthening Device

2017 ◽  
Author(s):  
Bolun Zhang ◽  
Daniel Farley ◽  
Heidi-Lynn Ploeg ◽  
Michael Zinn
Keyword(s):  
Real Time ◽  
Bone Growth ◽  
Healing Process ◽  
Unmet Need ◽  
Lower Limbs ◽  
Limb Length ◽  
External Fixators ◽  
Fixed Rate ◽  
Growth Plates ◽  
Control Approach

Lower limb length discrepancy (LLD), defined by unequal length of paired lower limbs, contributes to lower back pain, osteoarthritis of the hip, and stress fractures [1–3]. The Center for Disease Control and Prevention estimated that there were approximately 700 children born with LLD each year in US [4]. Patients may receive distraction osteogenesis treatment, in which an osteotomy is performed on the shorter limb, and mechanical force is applied to gradually distract the two halves of the bone during the healing process. This stretches the bone callus during healing to achieve desired limb length upon callus consolidation [5]. The current correction devices are external fixators that leave unsightly scars and are prone to infection [6]. While recently developed intramedullary devices address many of the persistent issues with external lengthening devices, size limitations and potential damage to the bone growth plates make them impractical for use in children [7, 8]. The proposed research addresses an unmet need by developing a novel implantable extramedullary device for LLD correction that is targeted for pediatric use. The device will be implantable, submuscular, and fixed to the outside surface of the bone (extramedullary), thus allowing for use in children without concern for injury to the growth plates. The device’s function will be similar to an external fixator; however, it will not require exposed hardware, which increases risk of infection, or muscle penetration from the pins, which causes pain. Additionally, the device incorporates real-time control of the distraction rate, reducing the risk of complications arising from fixed rate distraction such as premature consolidation and non-union of the callus. [9–11]. The investigators of this study have previously designed and constructed a distraction mechanism prototype and test frame [10]. The current study aims to validate the real-time controller of the prototype.

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