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BMC Musculoskeletal Disorders

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Open Access 01-12-2020 | Lower Leg Fracture | Research article

Outcomes of tissue reconstruction in distal lower leg fractures: a retrospective cohort study

Authors: Emrah Aydogan, Stefan Langer, Christoph Josten, Johannes Karl Maria Fakler, Ralf Henkelmann

Published in: BMC Musculoskeletal Disorders | Issue 1/2020

Abstract

Background

Open and closed fractures can be associated with posttraumatic or postoperative soft tissue defects caused by initial trauma, operative procedures, or infections. This study evaluated the postoperative outcomes in patients with open or closed lower leg fractures, related soft tissue defects, and subsequent flap coverage.

Methods

We performed a retrospective single-center cohort study in a level 1 trauma center. We analyzed the patients treated from January 2012 through December 2017 and recorded demographics, treatment, and outcome data. The outcome data were measured via patient-reported Foot and Ankle Outcomes Scores (FAOS) and EQ-5D-5L scores.

Results

We included 22 patients with complicated fractures (11 open and 11 closed) and subsequent soft tissue defects and flap coverages. The mean follow-up time was 41.2 months. Twenty-one patients developed infections, and necrosis at the site of surgery manifested in all closed fractures. Therefore, all patients needed soft tissue reconstructions. Preoperatively, 16 patients underwent arterial examinations via angiography and six underwent ultrasound examinations of the venous system. Ten patients had complications involving the flaps due to ischemia and consequent necrosis. The mean EQ-5D index was 0.62 ± 0.27, and EQ-5D VAS score was 57.7 ± 20.2. The mean FAOS was 60.7 ± 22.2; in particular, quality of life was 32.3 ± 28.8. The rate of returning to work in our patient group was 37.5% after 1 year.

Conclusions

Distal tibial fractures often require revisions and soft tissue reconstruction. The evaluated patient population had poor outcomes in terms of function, quality of life, and return to work. Furthermore, patients suffering from flap ischemia have worse outcomes than those without flap ischemia.

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Title: Outcomes of tissue reconstruction in distal lower leg fractures: a retrospective cohort study
Authors: Emrah Aydogan
Stefan Langer
Christoph Josten
Johannes Karl Maria Fakler
Ralf Henkelmann
Publication date: 01-12-2020
Publisher: BioMed Central
Keywords: Lower Leg Fracture
Distal Tibial Fracture
Published in: BMC Musculoskeletal Disorders / Issue 1/2020
Electronic ISSN: 1471-2474
DOI: https://doi.org/10.1186/s12891-020-03827-9

At a glance: The STEP trials

Springer Medicine

Outcomes of tissue reconstruction in distal lower leg fractures: a retrospective cohort study

Abstract

Background

Methods

Results

Conclusions

At a glance: The STEP trials

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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