A score for predicting salvage and outcome in Gustilo type-IIIA and type-IIIB open tibial fractures

作者: S. Rajasekaran , J. Naresh Babu , J. Dheenadhayalan , A. P. Shetty , S. R. Sundararajan

DOI: 10.1302/0301-620X.88B10.17631

关键词:

摘要: Limb-injury severity scores are designed to assess orthopaedic and vascular injuries. In Gustilo type-IIIA type-IIIB injuries they have poor sensitivity specificity predict salvage or outcome. We a trauma score grade the of injury covering tissues, bones functional grading three components from one five. Seven comorbid conditions known influence management prognosis been given two each. The was validated in 109 consecutive open tibia, 42 67 type-IIIB. total used possibilities outcome measured by dividing into four groups according their as follows: group I scored less than 5, II 6 10, III 11 15 IV 16 more. A 14 indicate amputation had highest specificity. Our compared favourably with Mangled Extremity Severity (98% 99%), (100% 17%), positive predictive value 97.5%) negative (70% 50%), respectively. receiver-operating characteristic curve constructed for efficiency salvage, showed that area under this better (0.988 (+/- 0.013 SEM)) (0.938 0.039 SEM)). All limbs underwent amputation. Of salvaged limbs, there significant difference requirement flap wound cover, time union, number surgical procedures required, days an in-patient incidence deep infection (p < 0.001 all). individual tissues were also found offer specific guidelines these complex scoring system be simple application reliable both limb-salvage measures tibia.

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