title: [Aggressive debridement and early soft tissue coverage of 3d degree open tibial fractures].
abstract: 93 patients with grade III open tibial fractures were treated without a treatment protocol from 1980 to 1982. This group is compared to 147 pts. managed between 1983 to 1986 according to a standardized prospectively designed protocol with aggressive debridement augmented by pulsatile Jet-lavage. Serial debridement were performed at 48-hour intervales until early soft-tissue coverage were obtained using local or free muscle-flaps. The mean follow-up was 80 months respectively 44 months. --The aggressive regimen led to a statistically significant decrease in infection (30% vs 12%), nonunion (16% vs 6%), amputation (18% vs 6%) and combined hospitalization-periods (137 vs 74 days) [all p less than 0.001]. The aggressively treated groups showed a trend toward early fracture-healing (30 vs 23 weeks) although this was not statistically significant.
authors.affiliation: Chirurgische Klinik, Technischen Universität München.
authors.forename: R L
authors.initials: RL
authors.lastname: Ketterl
authors.forename: H U
authors.initials: HU
authors.lastname: Steinau
authors.forename: A M
authors.initials: AM
authors.lastname: Feller
authors.forename: B
authors.initials: B
authors.lastname: Stübinger
authors.forename: B F
authors.initials: BF
authors.lastname: Claudi
mesh_terms: D000293:Adolescent; D000328:Adult; D016025:Bone Transplantation / Q000379:methods; D003646:Debridement / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D005592:Fracture Fixation / Q000379:methods; D005597:Fractures, Open / Q000601:surgery*; D006801:Humans; D008297:Male; D010019:Osteomyelitis / Q000601:surgery; D013524:Surgical Flaps; D007507:Therapeutic Irrigation / Q000379:methods; D013978:Tibial Fractures / Q000601:surgery*
vernacular_title: Aggressives Debridement und frühzeitige Weichteildefektdeckung bei drittgradig offenen Tibiafrakturen.