#PAGE_PARAMS# #ADS_HEAD_SCRIPTS# #MICRODATA#

TACTICS OF TREATMENT FOR OPEN FOREARM FRACTURES GRADE IIIB


Authors: R. Veselý;  V. Procházka ;  L. Paša
Authors place of work: Traumatological hospital Brno ;  Klinika traumatologie LFMU v Úrazové nemocnici Brno
Published in the journal: Úraz chir. 13., 2005, č.2

Summary

Open diaphyseal fractures of the forearm are frequently seen in motor vehicule trauma. The goal of the treatment of these serious and often disabling injuries must be prevention of infection, healing of soft tissue, healing of the fracture and functional restoration of the extremity. Plate osteosynthesis and intramedullary nail can be used in open fractures of the Ist and IInd type according to Gustilo. The external fixation is quick, safe and tissuesaving method indicated in open diaphyseal fractures of the forearm of type IIIB and IIIC incl. replantations. Defects of soft tissue should be covered by either local or free flap. There is a tendency to perform early covering. An integral part of the primary treatment is sufficiently radical debridement. Our group of 12 patients, operated on for open diaphyseal fracture of the forearm of type IIIB in the period from January 1999 to September 2004 was evaluated retrospectively. Types of osteosyntheses used, solution to soft tissus defects and complications are discussed.

Key words:
open fractures, forearm, external fixation.


Zdroje

1. CULLEN, J.P., Pellegrinni, V.D., MILLER, R.J. et al. Treatment of traumatic radioulnar synostosis by excision and postoperative lowdose radiation. J Hand Surg Am. 19, 1994, 3, 394–401.

2. DUMONT, C.E., THALMANN, R., MACY, J.C. The effect of rotational malunion of the radius and the ulna on supination and pronation. J Bone Joint Surg. 84B, 2002, 6, 1070–1074.

3. DUNCAN, R., GEISSLER, W., FREELAND, A.E. Immediate internal fixation of open fractures of the diaphysis of the forearm. J Orthop Trauma. 25, 1992, 6, 87–91.

4. FRANCEL, T., VANDER KOLK, C., HOOPES, J. et al. Microvascular soft tissue transplantation for reconstruction of acute open fractures: Timing of coverage and long term functional results. Plast Reconstr Surg. 89, 1992, 6, 478–481.

5. GODINA, M. Early microsurgical reconstruction of complex trauma of the extremities. Plast Reconstr Surg. 78, 1986, 3, 288–293.

6. GUSTILLO, R.B., MEKOW, R.L., TEMPLEMAN, D. The management of open fractures. J Bone Joint Surg. 72A, 1990, 2, 299–303.

7. GUSTILLO, R.B., MENDOZA, R.M., WILIAMS, D.N. Problems in the management of type III (severe) open fractures: A new classification of type III open fractures. J Trauma. 24, 1984, 8, 742–746.

8. HELBER, M.U., ULRICH, C. External fixation on forearm shaft fractures. Injury. 31C, 2000, 1, 45–47.

9. HERSOVICI, D., SCUDATO, J.M. Failures in fixation of the forearm. Techniques in Orthopedics. 17, 2002, 4, 409–415.

10. JONES, J.A. Immediate internal fixation of high energy open forearm fractures. J Orthop Trauma. 24, 1991, 5, 272–279.

11. JONES, D.J., HENLEY, M.B., SCHEMITSCH, E.H. et al. A biomechanical comparison of two methods of fixation of fractures of the forearm. J Orthop Trauma. 28, 1995, 9, 467–472.

12. LANGKAMER, V.G., Ackroyd, C.E. Internal fixation of forearm fractures in the 1980ś. Injury. 22, 1991, 2, 97–102.

13. MELLISINOS, E.G., PARKS, D.H. Posttrauma reconstruction with free tissue transfer. Analysis of 442 consecutive cases. J Trauma. 29, 1989, 11, 1095–1099.

14. MIN, A.D., COONEY, W.P., IDLER, R.S. et al. Long – term follow – up of forearm bone diaphyseal plating. Clin Orthop. 44, 1994, 4, 299–302.

15. RASMUSSEN, B.W., BAK, K., TONHOLM, C. External compression of forearm nonunion. A report on six cases. Acta Orthop Scand. 64, 1993, 7, 669–670.

16. RICHARDS, R.R. Chronic disorders of the forearm. J Bone Joint Surg. 78A, 1996, 5, 916–930.

17. SANDERS, R., Haidukewych, G.J., MILNE, T. et al. Minimal versus maximal plate fixation techniques of the ulna. J Orthop Trauma. 16, 2002, 2, 166–171.

Štítky
Surgery Traumatology Trauma surgery
Prihlásenie
Zabudnuté heslo

Zadajte e-mailovú adresu, s ktorou ste vytvárali účet. Budú Vám na ňu zasielané informácie k nastaveniu nového hesla.

Prihlásenie

Nemáte účet?  Registrujte sa

#ADS_BOTTOM_SCRIPTS#