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The Journal of Bone and Joint Surgery, Vol 69, Issue 6 801-807, Copyright © 1987 by Journal of Bone and Joint Surgery, Inc

JOURNAL CONTENTS

Severe open fractures of the tibia

RJ Caudle and PJ Stern

Sixty-two Type-III open fractures of the tibial shaft are reported on. Eleven were Type IIIA, and three of them had non-union while none were associated with deep infection or required secondary amputation. Forty-two were Type IIIB, and fifteen of them had non-union, twelve were associated with deep infection, and seven required secondary amputation. However, in the twenty-four Type-IIIB fractures that were treated with early restoration of the damaged soft tissue by local flaps or free tissue transfer, the rate of complications was significantly reduced to five non-unions, two deep infections, and two secondary amputations. Unfortunately, of the nine Type-IIIC injuries, seven ultimately required secondary amputation, from two days to sixty-three months after the initial injury, because of pain, sepsis, non-union, or failure of the vascular repair. Only two patients who had a Type-IIIC fracture have avoided amputation to date, and their results were poor.
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