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One-stage combined “fix and flap” approach for complex open Gustilo–Anderson IIIB lower limbs fractures: a prospective review of 102 cases

  • Trauma Surgery
  • Published:
Archives of Orthopaedic and Trauma Surgery Aims and scope Submit manuscript

Abstract

Background

Management of open fractures is challenging and requires a multidisciplinary team approach. This study aims to evaluate outcomes of open Gustilo–Anderson IIIB fractures managed at a single Ortho-Plastic centre following One-stage “Fix and Flap” approach.

Methods

Prospective data review for patients presenting with Gustilo–Anderson IIIB Fractures to our centre and managed with one-stage “Fix and Flap” approach. Postoperative outcomes are presented only for the patients who had a minimum of 12 months postoperative follow-up.

Results

120 patients were included (83 males and 37 females). Mean age was 43 years (10–96). Tibia diaphysis was the most common site of injury (60%). 55.9% of injuries were road traffic accidents (RTA). 102 out of 120 patients had a minimum of 12 months follow-up (mean follow-up duration 25 months). Meantime from injury until definitive surgery was 7.71 days. Primary union achieved in 86.73%. Delayed union was encountered in 10.20%. 3.06% of patients had non-union. Limb salvage rate was 97.05% and Deep infection rate was only 0.98%.

Conclusion

Our results showed that low infection rate, high limb salvage rate, and high union rate can be achieved in these complex injuries with meticulous technique, combined Ortho-Plastic (Fix and Flap) approach, and MDT input.

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Acknowledgements

The Authors would like to thank Dr Zak Ferguson, and Dr Benjamin Sephton for their help in data collection for this project.

Funding

This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.

Author information

Authors and Affiliations

  1. Trauma and Orthopaedics, Manchester University NHS Foundation Trust, Southmoor Rd, Wythenshawe, Manchester, M23 9LT, UK

    Ahmed Aljawadi, Amirul Islam, Noman Jahangir & Noman Niazi

  2. ST5 Spine Department, Royal Orthopaedic Hospital NHS Foundation Trust, Birmingham, B31 2AP, UK

    Mohammed Elmajee

  3. Consultant Plastic Surgery, Manchester University NHS Foundation Trust, Southmoor Rd, Wythenshawe, Manchester, M23 9LT, UK

    Adam Reid & Jason Wong

  4. Consultant Trauma and Orthopaedics, Manchester University NHS Foundation Trust, Southmoor Rd, Wythenshawe, Manchester, M23 9LT, UK

    Anand Pillai

Authors
  1. Ahmed Aljawadi
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  2. Amirul Islam
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  3. Noman Jahangir
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  4. Noman Niazi
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  5. Mohammed Elmajee
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  6. Adam Reid
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  7. Jason Wong
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  8. Anand Pillai
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Contributions

AA: Literature review, data collection and Analysis, Manuscript writing. AI: Literature review, Data collection and analysis, Critical review and drafting. NJ: Literature review, Data collection and analysis, Critical review and drafting. NN: Data analysis, Critical review and drafting. ME: Literature Review, Drafting and Critical analysis. AR: Operating surgeon, Data Collection, Critical review and drafting. JW: Operating surgeon, Data Collection, Critical review and drafting. AP: Operating surgeon, Data Collection, Data analysis, Manuscript Writing, Drafting and Critical analysis.

Corresponding author

Correspondence to Ahmed Aljawadi.

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This article does not contain any studies with human participants or animals performed by any of the authors.

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

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Aljawadi, A., Islam, A., Jahangir, N. et al. One-stage combined “fix and flap” approach for complex open Gustilo–Anderson IIIB lower limbs fractures: a prospective review of 102 cases. Arch Orthop Trauma Surg 142, 425–434 (2022). https://doi.org/10.1007/s00402-020-03705-y

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