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European Journal of Orthopaedic Surgery & Traumatology

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Open Access 01-07-2019 | Tibia Fracture | Original Article • LOWER LIMB - FRACTURES

How common are vascular injuries in open tibial fractures? A prospective longitudinal cohort study

Authors: O. O’Malley, A. J. Trompeter, S. Krishnanandan, M. Vesely, P. Holt, G. Goh, N. Papadakos, V. Bhatia, C. B. Hing

Published in: European Journal of Orthopaedic Surgery & Traumatology | Issue 5/2019

Abstract

Background

Tibial fractures have an incidence of 15% of all adult fractures. They have been shown to have the highest incidence of non-union in long bone fractures and the highest incidence of vascular injury. Evidence from the literature suggests that a good vascular supply is important to ensure bone union. The aim of our study was to prospectively assess the incidence of vascular injuries in open tibial fractures and determine whether they were associated with an increased risk of non-union.

Methods

We performed a prospective study to investigate the incidence of arterial injuries with computed tomography angiography (CTA) in patients with Gustilo–Anderson grade I–III open tibial fractures between 2013 and 2015. CTA was performed with the trauma series at acute admission and reported by two independent musculoskeletal radiologists. Patients were followed up with clinical and radiographic assessment for 1 year.

Results

We recruited 77 patients into the study, and 56 patients (47 males, 9 females) were available for the final analysis, between 16 and 90 years of age. At the initial assessment, 29% had signs of arterial injury with active extravasation in 5%. The most common site of injury was in the diaphysis (87.5%), and the commonest mechanism was a road traffic accident. We found no significant relation between occult vascular injury and non-union (p > 0.05).

Conclusion

The incidence of vascular injury in open tibial fractures is 29%, and CTA is therefore a useful test in identifying vascular injuries that may require vascular intervention.

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Title: How common are vascular injuries in open tibial fractures? A prospective longitudinal cohort study
Authors: O. O’Malley
A. J. Trompeter
S. Krishnanandan
M. Vesely
P. Holt
G. Goh
N. Papadakos
V. Bhatia
C. B. Hing
Publication date: 01-07-2019
Publisher: Springer Paris
Keywords: Tibia Fracture
CT Angiography
Published in: European Journal of Orthopaedic Surgery & Traumatology / Issue 5/2019
Print ISSN: 1633-8065
Electronic ISSN: 1432-1068
DOI: https://doi.org/10.1007/s00590-019-02416-4

Keynote webinar | Spotlight on medication adherence

Springer Medicine

How common are vascular injuries in open tibial fractures? A prospective longitudinal cohort study

Abstract

Background

Methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusion

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