ABSTRACT
The results of the treatment of 557 open fractures of the leg are discussed from the standpoint of healing of the fractures. According to the severity of the fracture the patients have been ranked into 3 groups. Although in 95,1% of the patients recovery was obtained, in 50% of severe injuries healing occurred only over 20 weeks. The time of recovery was influenced unfavourably by the non stable osteosyntheses. Conservative treatment performed in a great number of patients yielded satisfactory results. The number of the cases treated with stable osteosynthesis is relatively small for comparison with the former groups. In the authors' opinion, the classification of the cases according to the severity of the fracture is of great importance, since it influences the treatment, the recovery time as well as the prognosis.
Subject(s)
Fracture Fixation/methods , Fractures, Bone/classification , Fractures, Open/classification , Leg Injuries/classification , Adult , Aged , Casts, Surgical , Fracture Fixation, Internal , Fracture Fixation, Intramedullary , Fractures, Open/surgery , Fractures, Open/therapy , Humans , Leg Injuries/surgery , Leg Injuries/therapy , Middle Aged , Tibial Fractures/surgeryABSTRACT
Out of 557 open fractures of the leg we have analysed 472 cases in respect of recovery. We tried to discrive the relationship between the infection and the severity of the lesion and the methods of treatment resp. We have analysed also the further course of the infect.on. In our material considerable risk of the infections in the case of open leg fractures was found, since the incidence of all infections corresponded--in accordance with the data of the literature--to 16,7% of the appreciable cases. Significant relationship between the occurrence of infections and the severity of the lesion was found. In the material analysed according to the ACD code the incidence of infections is in the severely injured patients three times as much as in the case of slight or moderately severe groups. The occurrence of posttraumatic osteitis corresponds to 9,11%--this latter is similarly in relation with the severity of the lesion. The infection leads to the protraction of the osseous union,--however, no convincing data were found in the authors' material in respect of the relationship between the infection and the methods of treatment. The course and the proportion of healing of the infected cases correspond to the mean values reported in the literature. On the basis of their great material it is stated by the authors that only in the case of lesions with identical or at the least similar severity comparison of the results of recovery or of the complications is possible and suitable.
