title: Treatment of type IIIa open fractures with Ilizarov fixation and delayed primary closure in high-velocity gunshot wounds.
abstract: A total of 142 patients with 163 Gustilo-Anderson type IIIa limb fractures resulting from high-velocity gunshot wounds were treated with primary delayed closure and Ilizarov fixation in our department between 1988 and 1998. Average follow-up was 72.4 months. The average union period in fractures without bone loss was 16.8 weeks. It took 2 months for each 1 cm of bone defect to heal in fractures with bone loss. All fractures healed with good anatomic alignment and functional outcomes. Complications included pin-track infection in 72 fractures (50.7%), post-traumatic osteomyelitis in 5 tibial fractures without bone loss (3.1%), delayed union in 25 fractures (15.3%), nonunion in 10 (4 with bone loss) fractures (6.1%), and refracture in 4 fractures (2.4%). Our results indicate that type IIIa limb fractures caused by high-velocity gunshot wounds can be treated with Ilizarov fixation and primary delayed closure with a low overall complication rate and a remarkably low infection rate.
authors.affiliation: Department of Orthopaedics and Traumatology, Gülhane Military Medical Academy, 06018 Ankara, Turkey.
authors.forename: Ali Sabri
authors.initials: AS
authors.lastname: Atesalp
authors.forename: Cemil
authors.initials: C
authors.lastname: Yildiz
authors.forename: Mustafa
authors.initials: M
authors.lastname: Başbozkurt
authors.forename: Ethem
authors.initials: E
authors.lastname: Gür
mesh_terms: D000293:Adolescent; D000328:Adult; D001134:Arm Injuries / Q000601:surgery*; D005260:Female; D050723:Fractures, Bone / Q000601:surgery*; D006801:Humans; D018889:Ilizarov Technique; D007869:Leg Injuries / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D014948:Wounds, Gunshot / Q000150:complications / Q000601:surgery*