[article] 
inActa Orthopaedica Belgica > Vol 81/2 (Juin 2015) . - p.274-282

Titre :	Grade 3C Open Femur Fractures With Vascular Repair In Adults
Type de document :	texte imprimé
Auteurs :	Halil I. Balci, Auteur ; Yavuz SAGLAM, Auteur ; Onur TUNALI, Auteur
Année de publication :	2015
Article en page(s) :	p.274-282
Langues :	Anglais (eng)
Mots-clés :	Open femur fractures  Gustilo-Anderson  grade 3C open fracture  vascular injury  saphenous graft  ankle brachial index (ABI)
Résumé :	Grade 3C open femur fractures are challenging injuries with higher rates of complications. This is a retrospective review of grade 3C open femur fractures with vascular repair between 2002 and 2012. Outcomes included initial MESS score, additional injuries, duration of operation, complications, secondary operations or amputations, and social life implications. Thirty-one of 39 total patients were selected for revascularization and fracture fixation based on soft tissue injury and MESS score. The intra-operative approach included temporary arterial shunt replacement, orthopedic fixation, arterial reconstruction venous and/or nerve repair and routine fasciotomies. An external fixation and reverse saphenous vein graft was used in a majority of the patients (respectively; 93.5%, 90.3%). The mean follow up was 5.4 years (range 2.2-10). The decision to amputate versus salvage should be left up to patients and their care teams after discussing options and future possibilities rather than using a scoring system.
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[article] Grade 3C Open Femur Fractures With Vascular Repair In Adults [texte imprimé] / Halil I. Balci, Auteur ; Yavuz SAGLAM, Auteur ; Onur TUNALI, Auteur . - 2015 . - p.274-282.
Langues : Anglais (eng)
in Acta Orthopaedica Belgica > Vol 81/2 (Juin 2015) . - p.274-282

Mots-clés :	Open femur fractures  Gustilo-Anderson  grade 3C open fracture  vascular injury  saphenous graft  ankle brachial index (ABI)
Résumé :	Grade 3C open femur fractures are challenging injuries with higher rates of complications. This is a retrospective review of grade 3C open femur fractures with vascular repair between 2002 and 2012. Outcomes included initial MESS score, additional injuries, duration of operation, complications, secondary operations or amputations, and social life implications. Thirty-one of 39 total patients were selected for revascularization and fracture fixation based on soft tissue injury and MESS score. The intra-operative approach included temporary arterial shunt replacement, orthopedic fixation, arterial reconstruction venous and/or nerve repair and routine fasciotomies. An external fixation and reverse saphenous vein graft was used in a majority of the patients (respectively; 93.5%, 90.3%). The mean follow up was 5.4 years (range 2.2-10). The decision to amputate versus salvage should be left up to patients and their care teams after discussing options and future possibilities rather than using a scoring system.
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