What is the most appropriate gustiloanderson classification of this injury. Tibial nail combined with vacuum sealing drainage for. Comparative study of 24hour versus fiveday prophylactic. Gustilo modified the classification in 1984, dividing the type iii fractures into further subtypes. For the treatment of gustiloanderson type 3b open tibial fractures, early treatment of the softtissue defect is vital.
We surgically treated a gustilo anderson type 3b open tibial fracture with gastrocnemius muscle and soleus muscle flaps, along with an additional proximally based flexor hallucis longus flap, which is a rare procedure. For the treatment of gustilo anderson type 3b open tibial fractures, early treatment of the softtissue defect is vital. Furthermore, few institutions and practitioners are able to perform free flap transfer within 24 h. The gustilo classification of open compound fractures located in the extremities is based on criteria that include trauma severity, size, injury to vascular and soft tissue, degree of displacement, and injury contamination 1, 2. Read gustiloanderson classification, clinical orthopaedics and related research on deepdyve, the largest online rental service for scholarly research with thousands of academic publications available at your fingertips. Read the orthoplastic management of gustilo grade iiib fractures of the tibia in children. A gustilo type 3b open tibial fracture treated with a. Prognostic value of the modified gustiloanderson classification system assists with determination of treatment course. Use of antimicrobials in the management of open fractures. Fracturas abiertas gustilo y anderson traumatologia herida.
Patients with open tibia fractures treated with reamed intramedullary nail imn across a 10year period were evaluated. We sought to conduct the largest retrospective study to date of open tibia fractures and describe the incidence of complications and evaluate the potential predictive risk factors for complications. One hundred and thirty seven consecutive patients with a gustiloanderson type iiib open diaphyseal tibia fracture otaao 42 treated between may 2014 and january 2018. It is widely accepted for research, communication, and training purposes, and its remains useful as a good, basic approach to manage open fractures. At a level1 pediatric trauma center, 96 patients younger than 18 y who sustained gustiloanderson grade ii and iiia open long bone fractures humerus, radius, ulnar, femur, or tibia within a 10year period 20062016 were included for this study. A 45yearold man sustained a left open pilon fracture and fibular fracture and a length of 4 cm wound exited around the medial side of ankle ruediallgower type iii and gustiloanderson type ii. What is the most appropriate gustilo anderson classification of this injury. Open reduction and internal fixation of gustilo typei and. Gustiloanderson classification, clinical orthopaedics and.
Gustilo anderson iii b open tibial fractures are more difficult to manage than i, ii, and iii a fractures. Gustilo anderson classification radiology reference article. Gustilo and anderson were the first to stratify open fractures into types i, ii and iii with worsening severity and prognosis particularly infection, mainly for tibial fractures. We surgically treated a gustiloanderson type 3b open tibial fracture with gastrocnemius muscle and soleus muscle flaps, along with an additional proximally based flexor hallucis longus flap, which is a rare procedure.
Sep 22, 2016 we sought to conduct the largest retrospective study to date of open tibia fractures and describe the incidence of complications and evaluate the potential predictive risk factors for complications. The gustilo open fracture classification system is the most commonly used classification system for open fractures. Decision for epwc versus dwc was at the discretion of the attending. Download as ppt, pdf, txt or read online from scribd. Cancelleous bone graft dianjurkan diberikan setelah luka benar benar sembuh yaitu 4 6 minggu setelah prosedur penutupan luka. The gustilo anderson classification, also known as the gustilo classification, is the most widely accepted classification system of open or compound fractures the grading system is used to guide management of compound fractures, with higher grade injuries. This system uses the amount of energy, the extent of softtissue injury and the extent of contamination for determination.
This system uses the amount of energy, the extent of softtissue injury and the extent of contamination for determination of fracture severity. However, the gustiloanderson classification is limited because it seeks to contain an almost limitless variety of injury patterns, mechanisms, and severities with a small number of discrete categories. Management of gustilo anderson iii b open tibial fractures. Gustilo anderson type 3b open tibial fractures, reconstruction should ideally be performed within 24 h using free flap transfer. Download as pptx, pdf, txt or read online from scribd. Management of gustiloanderson type ii and iiia open long. Herida 10cm fuera hacia dentro segmentarias iiib 10cm fuera hacia dentro multifragmentarias iiic 10cm fuera hacia dentro multifragmentarias. Update to practice management guidelines for prophylactic antibiotic use in open fractures william s. An ideal classification system should guide treatment decisions rather than the treatment. Prevention of infection in the treatment of one thousand and twentyfive open fractures of long bones. The gustilo anderson classification, also known as the gustilo classification, is the most widely accepted classification system of open or compound fractures the grading system is used to guide management of compound fractures, with higher grade injuries associated with higher risk of complications.
Gustilo open fracture classification orthopaedicsone. Baixe no formato pptx, pdf, txt ou leia online no scribd. Overview of treatment for open fractures includes tetanus immunization, copious wound irrigation, operative debridement. Tibial nail combined with vacuum sealing drainage for gustilo. At a level1 pediatric trauma center, 96 patients younger than 18 y who sustained gustilo anderson grade ii and iiia open long bone fractures humerus, radius, ulnar, femur, or tibia within a 10year period 20062016 were included for this study.
Fractures in the grade iiib category are 10cm open fractures that are associated with extensive soft tissue loss but no substantial vascular damage. Open fracture of the distal radius and ulna, gustilo type i. All patients were treated using a small fragment adjunctive plate to hold the fracture reduced prior to. Thorough debridement and traction of calcaneal tubercle were applied within 24 h. We surgically treated a gustiloanderson type 3b open tibial fracture with gastrocnemius muscle and soleus muscle flaps, along with. Menurut gustilo, fraktur terbuka tipe iii dengan kerusakan jaringan yang luas memiliki komplikasi delayed union atau non union hingga 60%. Gustilo open fracture classification classifies into three major categories types depending on the mechanism of the injury, soft tissue damage, and degree of skeletal involvement.
Gustilo anderson classification radiology reference. May 09, 2012 read gustilo anderson classification, clinical orthopaedics and related research on deepdyve, the largest online rental service for scholarly research with thousands of academic publications available at your fingertips. Case report a gustilo type 3b open tibial fracture treated. As gustilo anderson type iii fractures are an independent risk factor for increased complication rates, a subgroup analysis was conducted to investigate if there were any differences in outcomes. Management of gustiloanderson type ii and iiia open long bo. It was created by ramon gustilo and anderson, and then further expanded by gustilo, mendoza, and williams.
Exposicion fracturas expuestas linkedin slideshare. Hendrich, en alemania, 12 reporto en 2004 una tasa. From march 2015 to march 2017, cases of gustilo grade iiib open tibial fractures were treated with expert tibial nails combined with vsd. Prognostic value of the modified gustilo anderson classification system assists with determination of treatment course. Most injuries involved the distal tibia n 8and were metaphyseal n 8. Clasificacion gustilo anatomia humana medicina clinica. Plate assisted intramedullary nailing of gustilo type iiib o. Bone grafting via reamerirrigatoraspirator for nonunion. Stable skeletal fixation with immediate soft tissue cover has been the key to the successful outcome in treating open tibial fractures, in particular, gustilo anderson iii b types. Bonadies, md, facs, riad cachecho, md, facs, fccp, and warren c. The gustiloanderson classification is widely used, and is the basic language with which many investigators communicate the results of open fracture treatment. Gustilo modified the classification in 1984, dividing the type iii fractures into further subtypes finding them too inclusive of a diverse array of injuries.
Plate assisted intramedullary nailing of gustilo type iiib. The gustilo anderson classification, despite its inherent limitations, is prognostically valuable for predicting orthopaedic infection 4, 16, 21. Govender s, csimma c, genant hk, valentinopran a, amit y. Plate assisted intramedullary nailing of gustilo type iiib open tibial diaphyseal fractures. We investigated the treatment effects of tibial intramedullary nails combined with vacuum sealing drainage vsd for gustilo grade iiib open tibial fractures.
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