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Open Tibia Shaft Fractures and Soft-Tissue Coverage: The Effects of Management by an Orthopaedic Microsurgical Team.


ABSTRACT: To compare the timing of soft-tissue (flap) coverage and occurrence of complications before and after the establishment of an integrated orthopaedic trauma/microsurgical team.Retrospective cohort study.A single level 1 trauma center.Twenty-eight subjects (13 pre- and 15 post-integration) with open tibia shaft fractures (OTA/AO 42A, 42B, and 42C) treated with flap coverage between January 2009 and March 2015.Flap coverage for open tibia shaft fractures treated before ("preintegration") and after ("postintegration") implementation of an integrated orthopaedic trauma/microsurgical team.Time from index injury to flap coverage.The unadjusted median time to coverage was 7 days (95% confidence interval, 5.9-8.1) preintegration, and 6 days (95% confidence interval, 4.6-7.4) postintegration (P = 0.48). For preintegration, 9 (69%) of the patients experienced complications, compared with 7 (47%) postintegration (P = 0.23).After formation of an integrated orthopaedic trauma/microsurgery team, we observed a 1-day decrease in median days to coverage from index injury. Complications overall were lowered in the postintegration group, although statistically insignificant.Therapeutic Level III. See Instructions for Authors for a complete description of levels of evidence.

SUBMITTER: VandenBerg J 

PROVIDER: S-EPMC5470841 | biostudies-literature | 2017 Jun

REPOSITORIES: biostudies-literature

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Open Tibia Shaft Fractures and Soft-Tissue Coverage: The Effects of Management by an Orthopaedic Microsurgical Team.

VandenBerg James J   Osei Daniel D   Boyer Martin I MI   Gardner Michael J MJ   Ricci William M WM   Spraggs-Hughes Amanda A   McAndrew Christopher M CM  

Journal of orthopaedic trauma 20170601 6


<h4>Objectives</h4>To compare the timing of soft-tissue (flap) coverage and occurrence of complications before and after the establishment of an integrated orthopaedic trauma/microsurgical team.<h4>Design</h4>Retrospective cohort study.<h4>Setting</h4>A single level 1 trauma center.<h4>Patients</h4>Twenty-eight subjects (13 pre- and 15 post-integration) with open tibia shaft fractures (OTA/AO 42A, 42B, and 42C) treated with flap coverage between January 2009 and March 2015.<h4>Intervention</h4>F  ...[more]

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