Open fractures of the tibia in the adult: surgical treatment and complications

Open fractures of the tibia in the adult: surgical treatment and complications

Open tibial shaft fractures represent high-energy trauma and are associated with a substantial risk of complications. Management is an emergency, and the first steps in treatment include antibiotic prophylaxis, tetanus booster, surgical debridement, irrigation of the wound and stabilization of the f...

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Bibliographic Details
Published in:Revue médicale suisse Vol. 7; no. 322; p. 2482, 2484
Main Authors: Kohlprath, R, Assal, M, Uçkay, I, Holzer, N, Hoffmeyer, P, Suva, D
Format: Journal Article
Language:French
Published: Switzerland 21-12-2011
Subjects:
Adult
Fractures, Open - surgery
Humans
Postoperative Care
Postoperative Complications - therapy
Preoperative Care
Tibial Fractures - surgery
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Summary:Open tibial shaft fractures represent high-energy trauma and are associated with a substantial risk of complications. Management is an emergency, and the first steps in treatment include antibiotic prophylaxis, tetanus booster, surgical debridement, irrigation of the wound and stabilization of the fracture. The Gustilo and Anderson classification helps to guide definitive treatment. Intramedullary nailing is the surgical technique of choice. An indirect approach utilizing external fixation is recommended for Gustilo IIIB and IIIC fractures. The most prevalent complications are compartment syndrome (10%), infection (2%-40% without antibiotics according to Gustilo grading, most notably in the presence of vascular lesions), aseptic nonunion (23%), venous thromboembolism (60% without prevention) and anterior knee pain (>50%).
ISSN:1660-9379