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MINERVA ORTOPEDICA E TRAUMATOLOGICA
A Journal on Orthopedics and Traumatology
BONE AND JOINT DEFORMITIES - SCIENTIFIC PAPERS 100° CONGRESS OF THE PIEMONTESE-LIGURIAN-LOMBARD SOCIETY OF ORTHOPAEDICS AND TRAUMATOLOGY (S.P.L.L.O.T.) - Pavia, June 20-21, 2003
Minerva Ortopedica e Traumatologica 2003 June;54(3):261-5
Bone deformities following severe fractures of the lower limbs
Bonaspetti G., Romeo R., Marchesi S., Pazzaglia U.E.
II Clinica Ortopedica, Spedali Civili, Università degli Studi, Brescia
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Deformities following severe multiple diaphysial fractures are the outcome of emergency surgical treatment and the inevitable consequence of fracture complexity. In the treatment of patients with multiple trauma, the orthopedic surgeon is often faced with the need to perform reduction and fixation as immediate therapy.
From 1998 to 2002 we treated and evaluated 37 patients with multiple trauma and severe fractures of the lower limbs (AO type C fractures). Twelve patients received emergency treatment because of open fracture, in 2 patients the injuries were associated with vascular damage.
Clinical outcome analysis included dysmetria, rotation defects, axis defects and joint deficits. The assessments were performed after the fractures had consolidated and the results had stabilized. The most commonly observed deformity was dysmetria in 2 severe cases (> 2 cm). The most severe defects were found to occur when emergency treatment was performed without immediate reduction and in cases of extremely complex fractures that made correct reduction nearly impossible.
Often, patients can be reoperated only some weeks later; this delay makes correct reduction of the fractures impossible. The analysis suggests that in patients with multiple trauma severe fractures should be treated with early fixation in emergency therapy.