RESEARCH ARTICLE


Update on the Management of Open Lower Limb Fractures



M Griffin1, M Malahias2, W Khan3, S Hindocha*, 4
1 Department of Surgery, St. Georges Hospital, Blackshaw Road, Tooting, London, SW17 0QT, UK
2 Department of Plastic Surgery, Birmingham Heartlands Hospital, Bordesley Green East, Birmingham, B9 5SS, UK
3 Royal National Orthopaedics Hospital, Stanmore, London, HA7 4LP, UK
4 Department of Plastic Surgery, Whiston Hospital, Liverpool, L35 5DR, 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

Open lower limb fractures pose a significant challenging pathology for orthopaedic and plastic surgeons to manage due to the combined soft tissue damage, bone loss and potential vascular compromise. These fracture 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 open 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 open tibial fractures using current evidence and recently updated UK guidelines. The optimal time for surgical debridement, surgical intervention, providing antibiotics and soft tissue coverage will be outlined as well as the indications for amputation.

Keywords: Open tibial fracture, lower limb fracture, amputation, gustilo and and Anderson score, wound debridement.