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- Title
Outcomes of Soft Tissue Reconstruction for Traumatic Lower Extremity Fractures with Compromised Vascularity.
- Authors
BADASH, IDO; BURTT, KAREN E.; ROUNDS, ALEXIS D.; AZADGOLI, BEINA; LELAND, HYUMA A.; GOULD, DANIEL J.; PATEL, KETAN M.; CAREY, JOSEPH N.
- Abstract
Traumatic lower extremity fractures with compromised arterial flow are limb-threatening injuries. A retrospective review of 158 lower extremities with traumatic fractures, including 26 extremities with arterial injuries, was performed to determine the effects of vascular compromise on flap survival, successful limb salvage and complication rates. Patients with arterial injuries had a larger average flap surface area (255.1 vs 144.6 cm2, P = 0.02) and a greater number of operations (4.7 vs 3.8, P = 0.01) than patients without vascular compromise. Patients presenting with vascular injury were also more likely to require fasciotomy [odds ratio (OR): 6.5, confidence interval (CI): 2.3-18.2] and to have a nerve deficit (OR: 16.6, CI: 3.9-70.0), fracture of the distal third of the leg (OR: 2.9, CI: 1.15-7.1) and intracranial hemorrhage (OR: 3.84, CI: 1.1-12.9). After soft tissue reconstruction, patients with arterial injuries had a higher rate of amputation (OR: 8.5, CI: 1.3-53.6) and flap failure requiring a return to the operating room (OR: 4.5, CI: 1.5-13.2). Arterial injury did not correlate with infection or overall complication rate. In conclusion, arterial injuries resulted in significant complications for patients with lower extremity fractures requiring flap coverage, although limb salvage was still effective in most cases.
- Subjects
SOFT tissue injuries; SURGICAL flaps; FASCIOTOMY; ODDS ratio; ARTERIAL injuries
- Publication
American Surgeon, 2017, Vol 83, Issue 10, p1161
- ISSN
0003-1348
- Publication type
journal article
- DOI
10.1177/000313481708301030