Abstract | BACKGROUND: The rates of soft tissue reconstruction and amputation after open tibial fractures have not been studied on a national perspective. We aimed to determine the frequency of soft tissue coverage after open tibial fracture as well as primary and secondary amputation rates. METHODS: Data on all patients (> = 15 years) admitted to hospital with open tibial fractures were extracted from the Swedish National Patient Register (1998-2010). All surgical procedures, re-admissions, and mechanisms of injury were analysed accordingly. The risk of amputation was calculated using logistic regression (adjusted for age, sex, mechanism of injury, reconstructive surgery and fixation method). The mean follow-up time was 6 (SD 3.8) years. RESULTS: Of 3,777 patients, 342 patients underwent soft tissue reconstructive surgery. In total, there were 125 amputations. Among patients with no reconstructive surgery, 2% (n = 68 patients) underwent amputation. In an adjusted analysis, patients older than 70 years (OR = 2.7, 95%, CI = 1.1-6) and those who underwent reconstructive surgery (OR = 3.1, 95% CI = 1.6-5.8) showed higher risk for amputation. Fixations other than intramedullary nailing (plate, external fixation, closed reduction and combination) as the only method were associated with a significant higher risk for amputation (OR 5.1-14.4). Reconstruction within 72 hours (3 days) showed better results than reconstruction between 4-90 days (p = 0.04). CONCLUSIONS:
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Authors | Ulrika Tampe, Rüdiger J Weiss, Birgit Stark, Pehr Sommar, Zewar Al Dabbagh, Karl-Åke Jansson |
Journal | BMC surgery
(BMC Surg)
Vol. 14
Pg. 80
(Oct 16 2014)
ISSN: 1471-2482 [Electronic] England |
PMID | 25323662
(Publication Type: Journal Article)
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Topics |
- Amputation, Surgical
(statistics & numerical data)
- Female
- Follow-Up Studies
- Fractures, Open
(complications, epidemiology, surgery)
- Humans
- Incidence
- Lower Extremity
(surgery)
- Male
- Middle Aged
- Plastic Surgery Procedures
(statistics & numerical data)
- Retrospective Studies
- Soft Tissue Injuries
(epidemiology, etiology, surgery)
- Sweden
(epidemiology)
- Tibial Fractures
(complications, epidemiology, surgery)
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