RESEARCH ARTICLE


Update on the Management of Compound Lower Limb Fractures



M Griffin1, M Malahias2, S Hindocha*, 3, W Khan4
1 Georges Hospital, London, UK
2 Heart of England NHS Foundation Trust, Birmingham, UK
3 Whiston Teaching Hospital, Liverpool, UK
4 Royal National Orthopaedic Hospital, London, UK


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© Griffin et al.; Licensee Bentham Open.

open-access license: This is an open access article licensed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted, non-commercial use, distribution and reproduction in any medium, provided the work is properly cited.

* Address correspondence to this author at the Department of Plastic Surgery, Whiston Hospital, Liverpool, L35 5DR, UK; Tel: 01244366265; Fax: 01244366265; E-mail: hindocha2001@yahoo.com


Abstract

Compound lower limb fractures pose a significant challenging pathology for orthopaedic and plastic surgeons to manage due to the combined soft tissue damage, bone injury and potential vascular compromise. These fractures require extensive team-work and expertise between several surgical specialties and the advice of non-surgical specialties, to ensure good clinical outcomes. Extensive research has improved the outcomes of compound lower limb fractures and current recommendation on the optimal management is always being updated to enhance patient outcomes. This review serves to provide an overview of the management of compound tibial fractures using current evidence and recently updated UK guidelines. The optimal time for surgical debridement, surgical intervention, antibiotic regime and soft tissue coverage will be outlined as well as the indications for amputation.

Keywords: Compound tibial fracture, lower limb fracture, amputation, Gustillo and Anderson score, wound debridement.