Title: Application of damage control orthopaedics in the management of type III open tibia fractures in a hilly region of North India
Authors: Tanveer Ahmed Bhat, Imtiyaz Ahmad Beigh, Sayar Ahmad Mantoo, Malik Naseer Ahmad, Zubair Ahmad Lone, Tanveer Ali, Karanbir Singh
DOI: https://dx.doi.org/10.18535/jmscr/v7i10.36
Abstract
Introduction: This study was conducted to analyse the outcomes of type III open tibia fractures arising out of high energy motor vehicle accidents in the hilly areas of Jammu province managed by applying the principles of damage control orthopaedics.
Methods: A retrospective study was carried out in seventeen patients with type III open tibia fractures. These patients were selected among the 243 cases that were injured in five major MVAs in the hilly areas of Jammu province between 2016 and 2019. External fixators were used for stabilisation of fractures in all patients on the first day of admission in Govt. Medical College and Hospital, Jammu according to principles of damage control orthopaedics.
Results: Bone union was achieved in fourteen patients. One patient needed amputation on the fifth post-op day. The mean time for bone union was 2.9 months (2 to 3.5 months) in case of conversion to internal fixation, and 6.5 months (2 to 15 months) when external fixation was extended and used as definitive method of fixation. No infectious complications were observed in the cases which underwent early conversion definitive fixation. After a mean follow-up of 24 months (7 to 30 months) fourteen patients recovered functionally and thirteen could return to duty with one patient still recovering from sciatic nerve injury.
Conclusion: This study highlights the utility of temporary external fixation as a damage control treatment modality in both preventing a second- hit phenomenon and enhancing bone healing and functional recovery in type III open tibia fractures.
Keywords: Damage control orthopaedics; External fixator; Tibia fracture; Motor Vehicle Accident; Open fracture.
