Analysis of Functional Outcome of Staged Treatment of Gustilo Anderson 3B Tibia Fractures: Experience from Tertiary Care Hospital of North India
Introduction: Open fractures of the tibia are the most common open long bone fractures, with an annual incidence of 3.4 per 100 000. The management of open tibia fractures with loss of skin and soft tissue coverage is complex and requires combined orthopaedic and plastic surgery expertise. Our objective was to analyse the functional outcome of staged treatment of Gustilo 3B tibia fractures.
Methodology: 30 cases of Gustilo Anderson 3b tibia fractures aged 18-70 years were recruited as study participants. Treatment was given in three stages. First stage included debridement and irrigation using normal saline followed by stabilization of fracture with external fixator application. Second stage involved skin flap or soft tissue repositioning with skin graft. Third stage was external fixator removal with internal fixation of bone with or without bone graft.
Results: All the patients were managed for injury and fracture with staged treatment protocol. All the skin flaps/grafts survived. During the internal fixation, 4 (13.3%) patients underwent bone grafting. Bone union occurred at predicted time in 28 cases. Treatment outcome was excellent in 63.3%, good in 23.3% and fair in 13.3% patients.
Conclusion: Management of such fractures is appropriately done using staged treatment approach. The treatment planning and execution should incorporate principles of infection control.
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Copyright (c) 2021 Sagar Arora, Kapil Bansal , Deepak John Bhatti , Radhe Shyam Garg , Durgesh Singh , Nikhil Gupta
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