Radical treatment of severe open fractures of extremities by orthoplastic surgery: a 10-year retrospective study

• Main Authors: Zhao Yang, Chao Xu, Yong-Gang Zhu, Jun Li, Zi-Xiang Wu, Ji-Wei Zou, Bao-Bao Xue, Dan-Min Miao, Lei Shang, Guang-Yue Zhao
• Format: Article
• Language: English
• Published: BMC 2021-05-01
• Series: Journal of Orthopaedic Surgery and Research
• Subjects: Soft tissue reconstruction; Severe open fractures; Orthoplastic; Masqualet
• Online Access: https://doi.org/10.1186/s13018-021-02479-2

Abstract Objective This study aimed to retrospectively analyze clinical data of a series of patients with severe open fractures of extremities (Gustilo IIIb or IIIc), who achieved a satisfactory outcome through radical orthoplastic surgery, so as to provide a reference for determining the treatment of severe open fractures of extremities. Methods The clinical data of 41 consecutive patients with severe open fracture (Gustilo IIIb or IIIc) of the limb, who underwent successful surgical debridement, fixation, and soft tissue reconstruction in one stage between January 2008 and January 2019, were retrospectively reviewed. Postoperative indicators, including infection rate and union time, were acquired by a regular follow-up and analyzed. Results The mean (±SD) age of the patients was 38 ± 16 years. A total of 90 open fractures and severe soft tissue damages were analyzed. The soft tissue cover was achieved within 72 h. The overall rate of infection was 14.6% (6/41). Sex and the Mangled Extremity Severity Score were associated with infection. The median union time of 40 patients (one amputation) was 32 weeks. Conclusion The overall rate of infection exhibited a lower tendency in this study compared with previous studies on high-grade open fractures following a two-stage orthopedic approach. The consequence of infection rate and union time was similar to that in previous studies. These results indicated that the single-stage radical orthoplastic treatment was an effective and reliable option for reconstructing severe open fractures.