This paper is only available as a PDF. To read, Please Download here.
Abstract
The initial treatment of complicated fractures several days old when first seen in
Afghan war wounded is reported for 52 limbs in 47 patients. External fixation was
the method of choice for stabilizing fractures in adults. In children, traction and
plaster-of-Paris were preferred.
In 30 cases (58 per cent) tissue damage was classified as moderate. With radical wound
toilet and delayed closure, infection could be controlled in most of these limbs.
In 15 fractures (29 per cent) there was severe laceration and exposure of bone. After
operation, deep infection persisted in three-quarters of these cases and the fate
of these limbs often seemed doubtful. The patients usually refused amputation. However,
of seven limbs (13 per cent) in which the fracture was associated with an arterial
injury, only one could be saved.
The brief period of observation of only 11 weeks does not permit assessment of time
to healing, frequency of late osteitis or definitive amputation rate. It seems, however,
that in spite of the lack of any proper first aid for these severe injuries, a functional
limb could be salvaged in over two-thirds of the cases, even with our modest resources.
To read this article in full you will need to make a payment
Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to InjuryAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
References
- Analysis of fractures treated in the Royal Victoria Hospital, Belfast, 1972 with special reference to gunshot wounds and bomb blast injuries.Injury. 1975; 6: 296
- Problems in the management of type III (severe) open fractures: a new classification of type III open fractures.J. Trauma. 1984; 24: 742
- Al-Rasheed military hospital external fixation for compound missile wounds of bone.Injury. 1984; 15: 388
- Treatment of complicated fractures of the lower leg by osteotaxis.J. Trauma. 1979; 19: 719
- External fixation of severe open tibial fractures with the Hoffmann frame.Clin. Orthop. 1983; 180: 68
- External fixation in war injuries.Injury. 1975; 6: 94
- The management of fractures in combat wounds.Ethiop. Med. J. 1982; 20: 193
- The treatment of open tibial shaft fractures from Vietnam War.J. Trauma. 1970; 10: 105
- External fixation in wartime limb surgery.Isr. J. Med. Sci. 1984; 20: 308
Article info
Publication history
Accepted:
November 17,
1986
Identification
Copyright
© 1987 Published by Elsevier Inc.
