title: The role of primary plastic surgery in the management of open fractures.
abstract: A study was undertaken to determine the requirement for primary plastic surgery in the treatment of open fractures. We reviewed 3297 consecutive open fractures in a 22-year period in a defined population. Analysis showed that 12.6% of patients required primary plastic surgery with 5.6% being treated with split skin grafting and 7.2% with a flap. Only 3.5% of open upper limb fractures required primary plastic surgery compared to 27.9% of open lower limb fractures. The fractures that required most primary plastic surgery were those of the femoral diaphysis and all fractures between the proximal tibia and the midfoot. The incidence of open fractures that require primary plastic surgery was 28/10(6)/year. The incidence in open upper and lower limb fractures was 5.3/10(6)/year and 22.7/10(6)/year respectively. Using these figures it is possible to estimate the numbers of open fractures that will require primary plastic surgery each year in the United Kingdom.
authors.affiliation: Royal Infirmary of Edinburgh, Little France, Edinburgh EH16 4SA, Scotland. Electronic address: charlescourtbrown@gmail.com.
authors.forename: Charles M
authors.initials: CM
authors.lastname: Court-Brown
authors.affiliation: Southmead Hospital, Southmead Way, Avon, Bristol BS10 5NB, United Kingdom.
authors.forename: Calum S
authors.initials: CS
authors.lastname: Honeyman
authors.affiliation: Royal Infirmary of Edinburgh, Little France, Edinburgh EH16 4SA, Scotland.
authors.forename: Nick D
authors.initials: ND
authors.lastname: Clement
authors.affiliation: St John's Hospital, Howden Road West, Howden, West Lothian EH54 6PP, Scotland.
authors.forename: Stuart A
authors.initials: SA
authors.lastname: Hamilton
authors.affiliation: Royal Infirmary of Edinburgh, Little France, Edinburgh EH16 4SA, Scotland.
authors.forename: Margaret M
authors.initials: MM
authors.lastname: McQueen
mesh_terms: D000328:Adult; D005260:Female; D005593:Fracture Fixation, Internal / Q000379:methods*; D005597:Fractures, Open / Q000150:complications / Q000453:epidemiology / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D019651:Plastic Surgery Procedures; D012606:Scotland / Q000453:epidemiology; D013518:Surgery, Plastic; D013524:Surgical Flaps; D013530:Surgical Wound Infection / Q000453:epidemiology / Q000517:prevention & control / Q000601:surgery*; D014193:Trauma Centers; D015599:Trauma Severity Indices; D016896:Treatment Outcome
keywords: Flap cover; Open fractures; Plastic surgery; Split skin grafting