Functional and Radiographic Outcomes of Open Proximal Femoral Fractures Caused by Gunshot Wounds in Yemen: A Prospective Cohort Study.

IF 2.3 Q2 ORTHOPEDICS

JBJS Open Access Pub Date : 2024-01-11 eCollection Date: 2024-01-01 DOI:10.2106/JBJS.OA.23.00085

Mohammad Hutaif, Abdullah Al-Moaish, Anwar Al-Fadliy

{"title":"Functional and Radiographic Outcomes of Open Proximal Femoral Fractures Caused by Gunshot Wounds in Yemen: A Prospective Cohort Study.","authors":"Mohammad Hutaif, Abdullah Al-Moaish, Anwar Al-Fadliy","doi":"10.2106/JBJS.OA.23.00085","DOIUrl":null,"url":null,"abstract":"Background: Open proximal femoral fractures caused by gunshot wounds are rare but devastating injuries that pose considerable challenges for prognosis and management. The aim of this study was to evaluate the functional and radiographic outcomes of patients with open proximal femoral fractures caused by gunshot wounds treated at 3 Level-I trauma centers in Yemen and to identify the factors that influence them.Methods: We prospectively enrolled 174 patients with open proximal femoral fractures caused by gunshot wounds. The fractures were classified according to the Gustilo-Anderson and OTA/AO systems. The primary outcome measures were fracture union, infection, and functional outcomes. The secondary outcome measures were the Harris hip score (HHS) and the Short Form-36 (SF-36) health survey score. We performed multivariable logistic regression modeling to identify the predictors of complications and poor functional outcomes.Results: The overall rate of fracture union was 87%. The complication rates were 18% for infection, 13% for nonunion, 23% for reoperation, 12% for delayed union, 4% for osteonecrosis, 6% for heterotopic ossification, and 2% for amputation. The mean HHS at the final follow-up was 78.4, and the mean SF-36 score was 67.3.Conclusions: Open proximal femoral fractures caused by gunshot wounds are associated with high rates of complications and poor functional outcomes in Yemen. Early debridement, appropriate fixation, infection control, and adequate soft-tissue coverage are essential for achieving satisfactory results. The type of wound, the type of fracture, and the type of definitive fixation are significant predictors of the outcomes. Future studies should compare different fixation methods and evaluate the long-term outcomes and complications of these injuries.Level of evidence: Therapeutic Level II. See Instructions for Authors for a complete description of levels of evidence.","PeriodicalId":36492,"journal":{"name":"JBJS Open Access","volume":"9 1","pages":""},"PeriodicalIF":2.3000,"publicationDate":"2024-01-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10773698/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"JBJS Open Access","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.2106/JBJS.OA.23.00085","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2024/1/1 0:00:00","PubModel":"eCollection","JCR":"Q2","JCRName":"ORTHOPEDICS","Score":null,"Total":0}

引用次数: 0

Abstract

Background: Open proximal femoral fractures caused by gunshot wounds are rare but devastating injuries that pose considerable challenges for prognosis and management. The aim of this study was to evaluate the functional and radiographic outcomes of patients with open proximal femoral fractures caused by gunshot wounds treated at 3 Level-I trauma centers in Yemen and to identify the factors that influence them.

Methods: We prospectively enrolled 174 patients with open proximal femoral fractures caused by gunshot wounds. The fractures were classified according to the Gustilo-Anderson and OTA/AO systems. The primary outcome measures were fracture union, infection, and functional outcomes. The secondary outcome measures were the Harris hip score (HHS) and the Short Form-36 (SF-36) health survey score. We performed multivariable logistic regression modeling to identify the predictors of complications and poor functional outcomes.

Results: The overall rate of fracture union was 87%. The complication rates were 18% for infection, 13% for nonunion, 23% for reoperation, 12% for delayed union, 4% for osteonecrosis, 6% for heterotopic ossification, and 2% for amputation. The mean HHS at the final follow-up was 78.4, and the mean SF-36 score was 67.3.

Conclusions: Open proximal femoral fractures caused by gunshot wounds are associated with high rates of complications and poor functional outcomes in Yemen. Early debridement, appropriate fixation, infection control, and adequate soft-tissue coverage are essential for achieving satisfactory results. The type of wound, the type of fracture, and the type of definitive fixation are significant predictors of the outcomes. Future studies should compare different fixation methods and evaluate the long-term outcomes and complications of these injuries.

Level of evidence: Therapeutic Level II. See Instructions for Authors for a complete description of levels of evidence.

查看原文本刊更多论文

也门枪伤所致开放性股骨近端骨折的功能和影像学结果：前瞻性队列研究

背景：枪伤导致的开放性股骨近端骨折是一种罕见的破坏性损伤，给预后和治疗带来了巨大挑战。本研究旨在评估也门 3 家一级创伤中心收治的枪伤所致开放性股骨近端骨折患者的功能和影像学预后，并确定影响预后的因素：我们对174名因枪伤导致的开放性股骨近端骨折患者进行了前瞻性登记。这些骨折根据古斯蒂洛-安德森（Gustilo-Anderson）和OTA/AO系统进行分类。主要结果指标为骨折愈合、感染和功能性结果。次要结果指标为哈里斯髋关节评分（HHS）和短表格-36（SF-36）健康调查评分。我们进行了多变量逻辑回归建模，以确定并发症和不良功能预后的预测因素：结果：总体骨折愈合率为87%。并发症发生率为：感染 18%、不愈合 13%、再次手术 23%、延迟愈合 12%、骨坏死 4%、异位骨化 6%、截肢 2%。最终随访的平均 HHS 为 78.4，平均 SF-36 评分为 67.3：在也门，枪伤导致的开放性股骨近端骨折并发症发生率高，功能预后差。早期清创、适当固定、感染控制和充分的软组织覆盖对取得满意的疗效至关重要。伤口类型、骨折类型和最终固定的类型是预测疗效的重要因素。未来的研究应比较不同的固定方法，并评估这些损伤的长期疗效和并发症：证据级别：治疗 II 级。有关证据级别的完整描述，请参阅 "作者须知"。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

JBJS Open Access Medicine-Surgery

CiteScore

5.00

自引率

0.00%

发文量

审稿时长

6 weeks