injuries of very different severity and prognosis. Type I injuries can involve the potentially harmful association of meniscal and ligamentary injuries, but Fraser type II fractures may cause such damage that meniscal and ligamentary integrity are almost
Josep Muñoz Vives, Jean-Christophe Bel, Arantxa Capel Agundez, Francisco Chana Rodríguez, José Palomo Traver, Morten Schultz-Larsen, and Theodoros Tosounidis
Abdel Rahim Elniel and Peter V. Giannoudis
Open fractures of the lower extremity are the most common open long bone injuries, yet their management remains a topic of debate.
This article discusses the basic tenets of management and the subsequent impact on clinical outcome. These include the rationale for initial debridement, antimicrobial cover, addressing the soft-tissue injury and definitive skeletal management.
The classification of injury severity continues to be a useful tool in guiding treatment and predicting outcome and prognosis. The Gustilo-Anderson classification continues to be the mainstay, but the adoption of severity scores such as the Ganga Hospital score may provide additional predictive utility.
Recent literature has challenged the perceived need for rapid debridement within 6 hours and the rationale for prolonged antibiotic therapy in the open fracture. The choice of definitive treatment must be decided against known efficacy and injury severity/type.
Recent data demonstrate better outcomes with internal fixation methods in most open tibial fractures, but external fixation continues to be an appropriate choice in more severe injuries. The incidence of infection and non-union has decreased with new treatment approaches but continues to be a source of significant morbidity and mortality.
Assessment of functional outcome using various measures has been prevalent in the literature, but there is limited consensus regarding the best measures to be used.
Cite this article: EFORT Open Rev 2018;3 DOI: 10.1302/2058-5241.3.170072
Maximilian M. Menger, Benedikt J. Braun, Steven C. Herath, Markus A. Küper, Mika F. Rollmann, and Tina Histing
fracture inferior or superior to the fovea centrals with an associated acetabular fracture. The Pipkin classification became the most frequently used classification system for fractures of the femoral head. Several studies evaluated the prognosis
Elisa Pala, Alberto Procura, Giulia Trovarelli, Antonio Berizzi, and Pietro Ruggieri
type of surgery. Wide bone resection and reconstruction with megaprostheses are indicated in young patients with good prognosis and health conditions, with single or oligo metastasis, favorable histotype, and long disease-free interval ( 1 ). When all
Deepak Samson, Chye Yew Ng, and Dominic Power
, provide an expected timeframe for recovery and ultimately an early prediction of prognosis for the patient. Extrinsic pressure from haematoma, fracture displacement or oedema may be alleviated, improving the prognosis for the continuity lesion. Neurolysis
Mario Herrera-Pérez, Pablo Martín-Vélez, David González-Martín, Miguel Domínguez-Meléndez, Ahmed E Galhoum, Victor Valderrabano, and Sergio Tejero
et al. in 2018, an ASA score >3 was also considered to be a bad prognosis risk factor ( 19 ). Diabetes – obesity Diabetes and obesity, which often go hand in hand, are highlighted in many publications as important risk factors for
Simon M. Lambert
affecting fracture healing with a judgement about the likely prognosis for healing and function based on a multiplicity of intrinsic (shoulder) and extrinsic (comorbid) factors. For any displaced fracture treated nonoperatively, the outcome will be defined
Alexandre Sitnik, Aleksander Beletsky, and Steven Schelkun
). 18 Classification According to Müller, the classification of fractures should reflect the severity of injury, the prognosis and possible treatment modalities. 19 In articles dealing with intra-articular distal tibial fractures, the
Allan Roy Sekeitto, Nkhodiseni Sikhauli, Dick Ronald van der Jagt, Lipalo Mokete, and Jurek R.T. Pietrzak
and limit unnecessary costs. Prognosis The one-year mortality of FNFs is 14–36%. 1 , 4 , 7 The 30-day mortality rate is 10%. 4 Mortality rates strongly correlate with age, living independence, mobility and mental status. 6 The
Ian Garrison, Grayson Domingue, and M. Wesley Honeycutt
be noted that there does not yet appear to be an ideal classification system that guides treatment and establishes prognosis with satisfactory interobserver reproducibility. It is important to identify two specific ST femur fracture patterns that