One-stage combined “fix and flap” approach for complex open Gustilo–Anderson IIIB lower limbs fractures: a prospective review of 102 cases

Ahmed Aljawadi, Amirul Islam, Noman Jahangir, Noman Niazi, Mohammed Elmajee, Adam Reid, Jason Wong, Anand Pillai

Research output: Contribution to journalArticlepeer-review

Abstract

Background: Management of open fractures is challenging and requires a multidisciplinary team approach. This study aims to evaluate outcomes of open Gustilo-Anderson IIIB fractures managed at a single Ortho-Plastic centre following One-stage "Fix and Flap" approach.

Methods: Prospective data review for patients presenting with Gustilo-Anderson IIIB Fractures to our centre and managed with one-stage "Fix and Flap" approach. Postoperative outcomes are presented only for the patients who had a minimum of 12 months postoperative follow-up.

Results: 120 patients were included (83 males and 37 females). Mean age was 43 years (10-96). Tibia diaphysis was the most common site of injury (60%). 55.9% of injuries were road traffic accidents (RTA). 102 out of 120 patients had a minimum of 12 months follow-up (mean follow-up duration 25 months). Meantime from injury until definitive surgery was 7.71 days. Primary union achieved in 86.73%. Delayed union was encountered in 10.20%. 3.06% of patients had non-union. Limb salvage rate was 97.05% and Deep infection rate was only 0.98%.

Conclusion: Our results showed that low infection rate, high limb salvage rate, and high union rate can be achieved in these complex injuries with meticulous technique, combined Ortho-Plastic (Fix and Flap) approach, and MDT input.
Original languageEnglish
Pages (from-to)425–434
Number of pages10
JournalArchives of orthopaedic and trauma surgery
Volume142
Issue number3
Early online date3 Jan 2021
DOIs
Publication statusPublished - Mar 2022

Keywords

  • open fracture
  • IIIB
  • Gustilo–Anderson
  • one-stage
  • ortho-plastic
  • fix and flap

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