Abstract:
AIM:To compare primary and secondary wound reconstruction as a treatment method for Gustilo type III open tibial fractures. METHODS:Thirty-five consecutive patients with a Gustilo type III open tibial shaft fracture were treated and followed up for 3 years. The patients were divided into two groups depending on the treatment protocol and timing of wound reconstruction: primary wound reconstruction (n=15) and secondary wound reconstruction (n=20). After determining median value, the variability was expressed with the 25th and 75th percentiles. RESULTS:In the primary wound reconstruction group, healing was achieved in 13 out of 15 patients. The median time to recovery was 68 (25th-75th percentile=32-86) weeks, median number of operations was 4 (25th-75th percentile=3-5), and median Johner and Wruhs score was 4 (25th-75th percentile=3-5). There were 9 cases with a bone defect and 2 tibial amputations were performed. In the secondary wound reconstruction group, complete recovery was achieved in 18 out of 20 patients. The median time to recovery was 115.5 (25th-75th percentile=70.0-128.5) weeks, median number of operations 7.5 (25th-75th percentile=6.5-8.5), and median score according to Johner and Wruhs' criteria 3 (25th-75th percentile=2-4). There were 19 cases with a bone defect and 1 tibial amputation was performed. Chronic osteomyelitis persisted only in a single patient. Median time to recovery and number of operations were significantly smaller in patients undergoing primary wound reconstruction. CONCLUSION:Primary wound reconstruction required smaller number of operations and shorter time to recovery than secondary wound reconstruction, mostly due to a significantly smaller proportion of cases with a bone defect.
journal_name
Croat Med Jjournal_title
Croatian medical journalauthors
Stalekar H,Fuckar Z,Ekl D,Sustić A,Loncarek K,Ledić Dkeywords:
subject
Has Abstractpub_date
2003-12-01 00:00:00pages
746-55issue
6eissn
0353-9504issn
1332-8166journal_volume
44pub_type
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