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

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Salvage or amputation for grade 3C open fracture of tibia is not well responded question universally because of surgical innovations, cultural believes, difficulties in estimate the outcome, coasts, and different results in the literature. The aim of this study was to evaluate the surgical outcomes of Gustilo grade 3C open tibia fractures with at least two years follow-up in non-military adults.


Twenty-two non-military patients with a mean age of 31.1 were operated with grade 3c open fractures at tibia level in last 10 years in our clinic. We evaluated them retrospectively and asked about their daily life, pain, and if present, about the wish for secondary amputation. We also asked if they would prefer a first day amputation rather than their present status.


Mean operation time after the injury was 13 h. Seven patients had nerve injury. Mean operation number was 3.5. Eight patients (%36) (all due to circulatory problem) had to have amputation. All patients treated with temporary unilateral external fixation than converted to circular external fixators when soft tissue healing was completed. Two patients were reoperated because of deformity. Four patients needed revision surgery because of non-union. At long term follow, we had osteomyelitis in one patient.


Scoring systems and the ischemic time are not the only predictors of amputation. The decision of the treatment mode should be made by the patient and the care team after discussing the options and outcomes rather than relying on a scoring system.

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Correspondence to O. Tunali.

Ethics declarations

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Conflict of interest

This study was approved by the institutional review board (IRB) of the Istanbul University, Istanbul Faculty of Medicine and has been done in Istanbul Medical Faculty, Department of Orthopedics and Traumatology, This study has not been published elsewhere before. It is not accepted for publication and under consideration by another publication. Each author (Onur Tunali, Halil Ibrahim Balci, Yavuz Saglam, Alauddin Kochai, Nuri Alper Sahbaz, Omer Ali Sayin and Onder Yazicioglu) certifies that he or she has no commercial associations that might pose a conflict of interest in connection with the submitted article.

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Informed consent was obtained from all individual participants included in the study.

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Tunali, O., Saglam, Y., Balci, H.I. et al. Gustilo type IIIC open tibia fractures with vascular repair: minimum 2-year follow-up. Eur J Trauma Emerg Surg 43, 505–512 (2017).

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