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12- SOFT TISSUE RECONSTRUCTION IN SEVERE OPEN LEG FRACTURES (GUSTILO TYPE III)

ZUHAIR F FATHALLAH --- ALI H KHUDAIR --- MAHMOOD A MAHMOODZ

Basrah Journal of Surgery مجلة البصرة الجراحية
ISSN: 16833589 Year: 2008 Volume: 14 Issue: 2 Pages: 66
Publisher: Basrah University جامعة البصرة

Abstract

Eighteen patients who sustained severe open leg fractures (Gustilo�s III) were treated in ALBasrahGeneral Hospital and Al-Sadder Teaching hospital between 2007 and 2008. Theywere12 males and 6 females, average age were 25 years. Middle third fractures occurred in 8cases (44.4%) and the comminuted geometry of fracture was in 14 patients (77.7%). All patientswere treated by meticulous wound excision with stabilization of fracture and then wound cover,which is done early in 6 patients (before 7 days) and late in 12 patients (after 7 days). Localmuscle flap was done in 9 patients (50%), local fasciocutanous flap in 6 patients (33.3%) andfree flap in 3(16.7%). The complications occurs more in late local reconstruction as flap infectionin (55.5%), nonunion in (33.3%), flap necrosis in (22.2%) and osteomylitis in (33.3%) while inearly reconstruction it is found only (16.6%) as a complication of each of the above. In muscleflap, flap infection found in (22.2%), flap necrosis in (11.1%) and nonunion in (22.2%) which waslower than other type of reconstruction, the muscle flap was more reliable flap in early period ofreconstructions. In conclusion, primary reconstruction of Gustilo's type III open tibial fractureshad advantages compared with secondary reconstruction.