In the Journals

Defined surgical approach of open tibia fracture debridement seen as safe for select patients

For certain patients, debridement of open tibia fractures through a defined surgical approach is safe and may lessen the need for flap coverage, according to results published in The Journal of Orthopaedic Trauma.

Among 66 patients with 68 open diaphyseal tibia fractures, Geoffrey S. Marecek, MD, and colleagues performed debridement of the open fracture through either a direct extension of the traumatic wound or through a defined surgical interval. Main outcome measures included the number of operations and the need for soft-tissue transfer.

Researchers performed direct extension of the traumatic wound in 47 patients and a defined surgical approach in 21 patients. Results showed similar proportions of Gustilo-Anderson and Orthopaedic Trauma Association open fracture classification subtypes. Researchers noted an average number of surgeries, including index procedure, per patient of 1.96 and 1.29 in the direct extension group and defined approach group, respectively. Nine patients in the direct extension group needed flap coverage vs. zero patients in the defined approach group.

“A thorough surgical debridement remains the most important step in preventing complications after an open tibia fracture,” Marecek told Healio.com/Orthopedics. “Surgeons have been using a defined approach for this purpose for some time. Now we have evidence that it is safe and effective. A thoughtful approach to exposing the entire zone of injury and performing debridement should be the goal, regardless of what approach is used.” – by Casey Tingle

Disclosures: Marecek reports he is a consultant for Globus Medical and ETEX. Please see the full study for a list of all other authors’ relevant financial disclosures.

For certain patients, debridement of open tibia fractures through a defined surgical approach is safe and may lessen the need for flap coverage, according to results published in The Journal of Orthopaedic Trauma.

Among 66 patients with 68 open diaphyseal tibia fractures, Geoffrey S. Marecek, MD, and colleagues performed debridement of the open fracture through either a direct extension of the traumatic wound or through a defined surgical interval. Main outcome measures included the number of operations and the need for soft-tissue transfer.

Researchers performed direct extension of the traumatic wound in 47 patients and a defined surgical approach in 21 patients. Results showed similar proportions of Gustilo-Anderson and Orthopaedic Trauma Association open fracture classification subtypes. Researchers noted an average number of surgeries, including index procedure, per patient of 1.96 and 1.29 in the direct extension group and defined approach group, respectively. Nine patients in the direct extension group needed flap coverage vs. zero patients in the defined approach group.

“A thorough surgical debridement remains the most important step in preventing complications after an open tibia fracture,” Marecek told Healio.com/Orthopedics. “Surgeons have been using a defined approach for this purpose for some time. Now we have evidence that it is safe and effective. A thoughtful approach to exposing the entire zone of injury and performing debridement should be the goal, regardless of what approach is used.” – by Casey Tingle

Disclosures: Marecek reports he is a consultant for Globus Medical and ETEX. Please see the full study for a list of all other authors’ relevant financial disclosures.