The role of primary plastic surgery in the management of open fractures

Summary A study was undertaken to determine the requirement for primary plastic surgery in the treatment of open fractures. We reviewed 3297 consecutive open fractures in a 22-year period in a defined population. Analysis showed that 12.6% of patients required primary plastic surgery with 5.6% being...

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Bibliographic Details
Published in:Injury 2015-12, Vol.46 (12), p.2443-2447
Main Authors: Court-Brown, Charles M, Honeyman, Calum S, Clement, Nick D, Hamilton, Stuart A, McQueen, Margaret M
Format: Article
Language:English
Subjects:
Adult
Female
Flap cover
Fracture Fixation, Internal - methods
Fractures, Open - complications
Fractures, Open - epidemiology
Fractures, Open - surgery
Humans
Male
Middle Aged
Open fractures
Orthopedics
Plastic surgery
Reconstructive Surgical Procedures
Scotland - epidemiology
Split skin grafting
Surgery, Plastic
Surgical Flaps
Surgical Wound Infection - epidemiology
Surgical Wound Infection - prevention & control
Surgical Wound Infection - surgery
Trauma Centers
Trauma Severity Indices
Treatment Outcome
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Summary:Summary A study was undertaken to determine the requirement for primary plastic surgery in the treatment of open fractures. We reviewed 3297 consecutive open fractures in a 22-year period in a defined population. Analysis showed that 12.6% of patients required primary plastic surgery with 5.6% being treated with split skin grafting and 7.2% with a flap. Only 3.5% of open upper limb fractures required primary plastic surgery compared to 27.9% of open lower limb fractures. The fractures that required most primary plastic surgery were those of the femoral diaphysis and all fractures between the proximal tibia and the midfoot. The incidence of open fractures that require primary plastic surgery was 28/106 /year. The incidence in open upper and lower limb fractures was 5.3/106 /year and 22.7/106 /year respectively. Using these figures it is possible to estimate the numbers of open fractures that will require primary plastic surgery each year in the United Kingdom.
ISSN:0020-1383
1879-0267
DOI:10.1016/j.injury.2015.09.037