exudates and Tibial-Fractures

Infection following grade IIIB open tibial fracture is common. The primary aim of managing this condition is to achieve control of infection before the bone reconstruction procedure is performed. The outcomes for such patients have not been evaluated in the literature. This study was conducted to examine the outcome of a multi-stage procedure for the treatment of infected grade IIIB open tibial fractures.. Between 2004 and 2008, we treated 11 patients with infected grade IIIB open tibial fractures in our unit. The management of infected grade IIIB open tibial fracture comprised three stages, which included serial debridement, wound closure by local flap surgery and bone reconstruction. The margin of resection and the type of bone reconstruction depended on the anatomical location of the disease, the extent of osteomyelitis and patient preference regarding treatment options. Bone reconstruction procedures included bone grafting, plating, interlocking nail, hybrid and monolateral external fixator, and Ilizarov bone transport.. Gram-negative organisms were isolated from all patients. Pseudomonas aeruginosa (P. aeruginosa) (44%) was the most common organism cultured. Infection was resolved in all patients. Nine fractures achieved union, with a mean union time of 15 months. Two patients with P. aeruginosa infection developed non-union of the fracture and refused additional surgery after three years of treatment.. The multi-stage management approach is well-accepted and effective in controlling infection in infected grade IIIB open tibial fractures.

Topics: Adult; Aged; Aged, 80 and over; Debridement; Female; Fracture Fixation; Fractures, Open; Fractures, Ununited; Humans; Ilizarov Technique; Malaysia; Male; Middle Aged; Osteomyelitis; Prospective Studies; Surgical Flaps; Tibial Fractures; Treatment Outcome; Wound Infection

The pattern of fracture, including the anatomical location and age distribution, may differ among urban and rural populations due to various factors such as the inhabitants' occupation and living environment.. This was a retrospective multicentre study involving two urban and three rural hospitals in Malaysia. The demographic data and anatomical location of fracture of patients admitted in 2007 were collected for analysis.. A total of 7,973 patients were admitted for fractures between January and December 2007. The femur was the commonest fracture site that required admission in the urban population (21.9 percent), followed by the tibia-fibula (18.7 percent), while the radius-ulna was the commonest site among the rural population (22.0 percent), followed by the tibia-fibula (19.4 percent). The rates of head and pelvic fractures were comparatively higher in the urban population, while hand fractures were more common in the rural population. The higher rate of femur fracture in the urban group, especially among the elderly, may be due to the higher incidence of osteoporosis or a higher proportion of older people in the population.. The anatomical locations of common fractures differed between the urban and rural populations. A higher rate of upper limb fractures was observed in the rural areas, while femur fractures in the elderly was the main cause of fracture admission in the urban areas. The relatively high rate of hand fractures in the rural areas, especially among children and young adults, may require further investigation.

Topics: Adolescent; Adult; Aged; Developing Countries; Female; Femoral Fractures; Fractures, Bone; Hospitals, Rural; Humans; Malaysia; Male; Middle Aged; Radius Fractures; Retrospective Studies; Rural Population; Tibial Fractures; Ulna Fractures; Urban Population

Open fracture of the tibia is very common among motorcyclists. The morbidity associated with this injury is well-documented as treatment of severe open fractures is very difficult. There is currently no study done in the literature to see the relationship between fracture severity and the side of the injury.. We reviewed 239 patients with open fractures of the tibia admitted to our institution from 1998 to 2002.. From 241 tibias studied, 150 (62.2 percent) involved the right side and 91 (37.8 percent) involved the left side. Statistical analysis showed that there was a significant difference in the severity of open fracture between the sides of fracture. Less severe injury (grades 1 and 2 fractures) was associated with injury of the left tibia and severe injury (grades 3A, B and C fractures combined) was associated with right tibia fracture.. Since the right leg was more exposed to the injury, it is imperative to protect the limb. This may reduce the overall incidence and severity of tibia fractures.

Topics: Accidents, Traffic; Adolescent; Adult; Aged; Aged, 80 and over; Child; Child, Preschool; Female; Fractures, Open; Humans; Incidence; Malaysia; Male; Middle Aged; Motorcycles; Retrospective Studies; Severity of Illness Index; Tibial Fractures

We report the results of external fixation in 29 patients treated for tibial fractures and tibial non-union using a novel multi axial external fixator (MAXX) followed prospectively until bony union. The results of treatment were classified according to the Association for the Study and Application of the Method of Ilizarov (ASAMI). Overall, 13 patients had excellent bone results; 13 had good bone results; two had fair bone results, and 1 patient had poor bone results. Regarding functional results, 21 patients had excellent results; 6 obtained good results; none had fair results, and two had poor results. Acute patients did better functionally than chronic patients. This fixator is safe and versatile, although the indications for its use are very specific.

Topics: Adolescent; Adult; Aged; Bone Transplantation; Developing Countries; Equipment Design; External Fixators; Female; Follow-Up Studies; Fracture Fixation; Fracture Healing; Fractures, Open; Fractures, Ununited; Humans; Malaysia; Male; Middle Aged; Prospective Studies; Reoperation; Tibial Fractures; Treatment Outcome

Topics: Arm Injuries; Child; Child, Preschool; Clavicle; Female; Femoral Fractures; Femur Head; Fibula; Fracture Fixation; Fractures, Bone; Humans; Humeral Fractures; Leg Injuries; Malaysia; Male; Radius Fractures; Tibial Fractures