Flap coverage in treating traumatic soft tissue defects - observation and outcome

Abstract

High energy traumas prompt Gustillo-Anderson type 3 open tibial fractures, which are frequently accompanied by potential consequences such as amputation, infection, nonunion, malunion, and soft tissue losses. Treatment options for open tibial fractures are largely decided by fracture characteristics, age, general patient condition, soft tissue situation, and circulatory properties. The preferred method must allow for maximum functional restoration of the extremities as well as optimal bone alignment and length. The goal of this study was to see how definitive management of Gustilo type III B tibia fractures with SIGN interlocking nail and wound coverage by muscle flap worked within 72 hours of injury.This was a single group clinical trial and was conducted in the National Institute of Traumatology and Orthopaedic Rehabilitation (NITOR), Dhaka from July 2004 to June 2006. Total population of the study was 12 which was sampled by purposive sampling method. Patients ages ranged from 18 to 48 years, with such a mean age of 34 years and a male to female ratio of 11:1. A traffic accident was the principal cause of the injuries. According to post-operative complications, 01 patient had superficial infection, 02 had restricted knee movements, and none had rotational or angulatory deformity. During this study, no patients suffered from neurovascular or compartment injury. According to Tucker et al. criteria, 11 (91.67%) patients had satisfactory outcomes, while 01 (8.33%) had unsatisfactory outcomes. The most difficult problem among all long bone injuries has been an open fracture of the Tibia fibula. Within 72 hours of injury, treatment of fracture tibia fibula Gustilo type IIIB by interlocking intramedullary nail and wound coverage by muscle or fasciocutaneous flap in Bangladesh may salvage a limb or reduce the prolonged sufferings to a minimum level; a clinical trial was conducted with this objective in mind.