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The e-mémoires of the Académie Nationale de Chirurgie

From War surgery to conventional traumatology : is it a benefit in teaching local flaps to orthopedic surgeons for the treatment of lower limb open fractures ?

Etienne MASSARDIER

Seance of wednesday 29 june 2022 (SÉANCE COMMUNE AVEC LE SERVICE DE SANTÉ DES ARMÉES À L'ÉCOLE DU VAL-DE-GRÂCE)

DOI number : 10.26299/qwcs-qs61/emem.2022.24.02

Abstract

Soft tissues management in open fractures is an essential step in their treatment. Often performed by a plastic surgeon, a high number of patient can be an overwork difficult to deal with. We studied the effect of the arrival of orthopedic surgeons trained to local flaps in our team.
63 patients were admitted for an open fracture of the lower limb, Gustilo 3b or 3c, or secondary open, until July 1st 2012 to July 1st 2021. 45 patients were included before July 1st 2018 and 18 after this date.
31 flaps were performed in 28 patients (62%) of the first group, and 20 flaps in 18 patients (100%) in the second. Median time to fracture cover was 28 days (17-52) versus 7 days (3-12) (p<0,05). There was no difference in failure rate between the two groups.

Keywords : Open fracture, Limb Salvage, Surgical Flap