[Changes in therapeutic principles in fractures of the extremities with severe soft tissue injuries exemplified by tibial fracture].

Abstract:

:Functional results after open fractures have been improved during the last decades. Especially the rates of amputation and chronic osteitis after open tibial fractures have been reduced from 30% to less than 5%. The initial management of this type of fracture includes reconstruction of the perfusion of the involved vessels, subsequent debridement with resection of avascular tissues, decompression of compartments by fasciotomy and initial shortening of the tibia by osteotomy and followed by callus distraction in order to achieve the physiological length of the leg. Cortical bone with periostal stripping has to be covered by local muscle transfer or by free vascularized tissue transfer within 3-7 days. Bone defects are either reconstructed by cancellous bone graft or, if the defect is longer than 2 cm, by continuous segmental transfer, according to the technique described by Ilizarov.

journal_name

Zentralbl Chir

authors

Dávid A,Ostermann PA,Möllenhoff G,Hebebrand D,Muhr G

subject

Has Abstract

pub_date

1997-01-01 00:00:00

pages

681-9

issue

8

eissn

0044-409X

issn

1438-9592

journal_volume

122

pub_type

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  • [Maggot therapy for treatment of severe infections in trauma surgery: "back to the future!"].

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  • [Surgery of proctologic diseases in the polyclinic].

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  • [Risk factors and pathogenic microorganisms in patients with insufficient esophagojejunostomy after gastrectomy].

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