Gustilo type IIIC open tibia fractures with vascular repair: minimum 2-year follow-up

Area of Science:

• Orthopedic Surgery
• Trauma Management

Background:

• Gustilo grade 3C open tibia fractures present complex treatment challenges.
• Variability in outcomes and treatment decisions necessitates further investigation.

Purpose of the Study:

• To evaluate surgical outcomes of Gustilo grade 3C open tibia fractures in non-military adults.
• To assess long-term results including functional status and patient satisfaction.

Main Methods:

• Retrospective analysis of 22 non-military adult patients with Gustilo grade 3C open tibia fractures.
• Mean follow-up of at least two years, assessing daily life, pain, and secondary amputation preference.

Main Results:

• Mean time to operation was 13 hours; 36% of patients required amputation due to circulatory issues.
• Average 3.5 operations per patient; common complications included nerve injury, deformity, non-union, and osteomyelitis.
• External fixation was used, with subsequent revisions for deformity and non-union.

Conclusions:

• Ischemic time and scoring systems are insufficient predictors of amputation.
• Treatment decisions for severe open tibia fractures should be collaborative, involving patients and care teams.