Primary plating osteosynthesis in open fractures

• Main Authors: Chandra Prakash Pal, Neeraj Mishra, Karuna Shankar Dinkar, Harish Kumar, Pulkesh Singh, R K Goyal
• Format: Article
• Language: English
• Published: Wolters Kluwer Medknow Publications 2014-01-01
• Series: Journal of Orthopedics, Traumatology and Rehabilitation
• Subjects: complication; injured; open fractures; plating; rehabilitation; soft tissue
• Online Access: http://www.jotr.in/article.asp?issn=0975-7341;year=2014;volume=7;issue=1;spage=64;epage=68;aulast=Pal

Introduction: The management of open fractures poses one of the greatest challenges to orthopaedic surgeons because it not only requires management of a contaminated soft tissue injury involving skin, muscles and neurovascular structures but also treatment of underlying fracture which is also contaminated. Primary internal fixation if done can solve many problems. With the use of internal fixation the fracture remain in good position so that soft tissue injuries can be handled easily and effectively. Materials and Methods: Present study was carried out in 12 skeletally mature patients. All open fractures of upper and lower extremities presenting within 12 hours of trauma were included in study. The wound was then cleaned and injured part was then splinted so that movement of fracture fragment causing further damage could be prevented. In operation theatre wound debridement was done before internal fixation under aseptic conditions. Results: Regarding soft tissue healing all the cases of grade I showed either good (66.67%) or fair (33.33%) results. Out of 4 cases of upper limb, 2 cases (50%) of grade I united within 4 months. One case of grade III of upper limb united in 6 months. Out of 8 cases of lower limb, 3 cases (37.5%) united within 5 months and 4 cases (50%) united within 6 months. One case of grade III fracture tibia showed delayed union, bone grafting was done in this case. Conclusion: We conclude from the study that the judicious selection of cases, skillful management of the injured limb and early rehabilitation is the key for compound fractures.