Summary
730 consecutive acute reamed intramedullary locked nailing of tibial fractures were studied, according to Gustilo’s classification of soft tissue lesions for the open fractures. There is a significant increase of post-operative infection rate if the tibial fracture is open, and the relative risk increases with the severity of soft tissue lesions. The comparison of these figures with those of other methods of treatment and the mechanical and clinical advantages of nailing leads us to propose this method for treatment of grade I, II and IIIa open fractures, while external the fixator seems better adapted for IIIb and c open fractures.
Résumé
Les auteurs ont étudié 730 enclouages centro-médullaires verrouillés avec alésage dans le traitement des fractures récentes du tibia, en tenant compte de la classification de Gustilo et Anderson. Ils ont trouvé une relation statistiquement significative entre le risque d’infection post-opératoire et la sévérité des lésions des parties molles. La comparaison entre l’enclouage verrouillé avec alésage, qui présente d’indiscutables avantages au plan mécanique et clinique, et les autres méthodes thérapeutiques, conduit les auteurs à proposer leur technique comme traitement de choix des fractures ouvertes de jambe de grade I, II et IIIa, tandis qu’il semble préférable d’utiliser la fixation externe pour les fractures ouvertes de grade IIIb et c.
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European Bone and Joint Infection Society Meeting, München, Germany, October 7–9, 1993
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Jenny, J.Y., Jenny, G. & Gaudias, J. The risk of post-operative infection after reamed intramedullary locked nailing of tibial fractures. A review of 730 cases. Eur J Orthop Surg Traumatol 5, 79–82 (1995). https://doi.org/10.1007/BF02716224
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DOI: https://doi.org/10.1007/BF02716224