title: Management of lower limb fractures in polytrauma patients with delayed referral in a mass disaster. The role of the Ilizarov method in conversion osteosynthesis.
abstract: Polytrauma cases in mass disasters present several challenges to the orthopaedic surgeon. Delayed referral, multisystem involvement and the requirement to manage coexisting injuries by interhospital transfer often make infection an inevitable risk. 28 patients with polytrauma were studied after being referred after being recovered from the debris of their homes in the Kashmir earthquake. All patients were referred more than 24h after sustaining their injuries. The lower limb fractures were fixed by external fixators in all these cases before interhospital transfer for the management of their co existing injuries. Return referral to the orthopaedic facility occurred after an average of 25 days. All cases were converted to Ilizarov fixation. The results bear out the fact that the Ilizarov method may be well suited for conversion osteosynthesis of lower limb fractures in polytrauma cases.
authors.affiliation: Department of Orthopaedics, Government Hospital for Bone and Joint Surgery, Barzullah, Srinagar, Kashmir, India. shabirdhar@yahoo.co.in
authors.forename: Shabir Ahmed
authors.initials: SA
authors.lastname: Dhar
authors.forename: Mohammed Farooq
authors.initials: MF
authors.lastname: Butt
authors.forename: Anwar
authors.initials: A
authors.lastname: Hussain
authors.forename: Mohammed Ramzan
authors.initials: MR
authors.lastname: Mir
authors.forename: Manzoor Ahmed
authors.initials: MA
authors.lastname: Halwai
authors.forename: Altaf Ahmed
authors.initials: AA
authors.lastname: Kawoosa
mesh_terms: D000328:Adult; D055866:Earthquakes; D016267:External Fixators / Q000592:standards*; D005260:Female; D005264:Femoral Fractures / Q000000981:diagnostic imaging / Q000601:surgery*; D006801:Humans; D018889:Ilizarov Technique / Q000592:standards*; D007194:India; D015601:Injury Severity Score; D008297:Male; D009104:Multiple Trauma / Q000601:surgery; D011183:Postoperative Complications / Q000517:prevention & control; D011859:Radiography; D012189:Retrospective Studies; D013978:Tibial Fractures / Q000000981:diagnostic imaging / Q000601:surgery*; D013997:Time Factors