Management of Gustilo-Anderson IIIB open tibial fractures in adults-a systematic review.

IF 6.7 2区医学 Q1 Medicine

British medical bulletin Pub Date : 2021-09-10 DOI:10.1093/bmb/ldab013

A Myatt, H Saleeb, G A J Robertson, Jana Keren Bourhill, P R J Page, A M Wood

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引用次数: 1

Abstract

Introduction: Open tibial fractures are the most common open long bone fracture, despite this, the management of these complex injuries still remains a topic of discussion amongst orthopaedic surgeons.

Sources of data: We searched the EMBASE, MEDLINE and Google Scholar and a systematic review of 7500 articles, leaving 23 after exclusion criteria were applied, in order to analyse the management of open tibial fractures.

Areas of agreement and controversy: Infection was noted to be the most significant concern amongst authors, with definitive external fixation having a high rate of superficial pin-site infection and internal fixation having a high deep infection rate.

Growing points: It is essential to have a combined ortho-plastic approach to the management of these fractures as muscle flaps were the most common form of soft tissue coverage.

Areas timely for developing research: A national pragmatic trial into the management of open tibial fractures is required looking at fixation methods and soft tissue coverage, with at least a 2-year follow-up in order to ascertain the most appropriate management of these fractures and patient-related outcomes.

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成人Gustilo-Anderson IIIB开放性胫骨骨折的治疗-一项系统综述。

开放性胫骨骨折是最常见的开放性长骨骨折，尽管如此，这些复杂损伤的处理仍然是骨科医生讨论的话题。数据来源:我们检索了EMBASE、MEDLINE和Google Scholar，并对7500篇文章进行了系统评价，在排除标准后，只剩下23篇，以分析开放性胫骨骨折的治疗。一致和争议的领域:感染被认为是作者最关心的问题，明确的外固定物具有高的表面针位感染率，而内固定物具有高的深部感染率。生长点:由于肌肉瓣是软组织覆盖最常见的形式，因此对这些骨折进行联合矫形治疗是至关重要的。及时开展研究的领域:需要开展一项针对开放性胫骨骨折治疗的全国性实用试验，研究固定方法和软组织覆盖范围，至少进行2年的随访，以确定最合适的骨折治疗方法和患者相关结果。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

British medical bulletin 医学-医学：内科

CiteScore

13.10

自引率

1.50%

发文量

审稿时长

>12 weeks

期刊介绍： British Medical Bulletin is a multidisciplinary publication, which comprises high quality reviews aimed at generalist physicians, junior doctors, and medical students in both developed and developing countries. Its key aims are to provide interpretations of growing points in medicine by trusted experts in the field, and to assist practitioners in incorporating not just evidence but new conceptual ways of thinking into their practice.