Differences between primary and secondary definitive osteosynthesis for fractures of the lower leg with concomitant acute compartment syndrome View Full Text


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Article Info

DATE

2019-02-12

AUTHORS

Christopher Ull, Oliver Jansen, Dominik Seybold, Matthias Königshausen, Thomas Armin Schildhauer, Jan Gessmann

ABSTRACT

PURPOSE: To analyze the differences in outcomes between primary and secondary definitive osteosynthesis for fractures of the lower leg with concomitant acute compartment syndrome (ACS). METHODS: From our trauma database, we identified a total of 107 patients with 126 fractures of AO/OTA type 41-44 and 120 ACS from January 01, 2001 to December 31, 2015 who were treated with primary or secondary definitive osteosynthesis after concomitant fasciotomy. RESULTS: Seventy-one patients with 77 fractures of AO/OTA classification type 41-44 suffering ACS received primary definitive osteosynthesis at the time of compartmental incision (POCI) and were compared to 36 patients with 49 fractures of AO/OTA type 41-44 and ACS, who received secondary definitive osteosynthesis after compartmental incision and soft tissue coverage (SOCI). Patients with POCI had a significantly shorter length of hospital stay with significantly fewer necessary surgeries to achieve definitive fracture treatment and soft tissue closure than SOCI patients (p ≤ 0.001). The overall rate of infections in both groups was 13%, without any difference between POCI and SOCI. CONCLUSIONS: POCI for AO/OTA fractures type 41-44 with ACS is a safe and effective procedure without increasing the infection rate compared to a gradual treatment (SOCI). However, the possible selection bias due to the retrospective study design needs to be considered. More... »

PAGES

1-7

References to SciGraph publications

  • 2015-09. Risk factors for acute compartment syndrome of the leg associated with tibial diaphyseal fractures in adults in JOURNAL OF ORTHOPAEDICS AND TRAUMATOLOGY
  • 2018-07. Chirurgische Zugänge bei Tibiakopffrakturen in DER UNFALLCHIRURG
  • 2010-04. Compartment Syndrome of the Lower Leg and Foot in CLINICAL ORTHOPAEDICS AND RELATED RESEARCH®
  • Identifiers

    URI

    http://scigraph.springernature.com/pub.10.1007/s00068-019-01089-2

    DOI

    http://dx.doi.org/10.1007/s00068-019-01089-2

    DIMENSIONS

    https://app.dimensions.ai/details/publication/pub.1112073904

    PUBMED

    https://www.ncbi.nlm.nih.gov/pubmed/30747274


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