Rahim, Mohamad Afif Ab
(2016)
The outcomes of delayed treatment for open fracture diaphyseal forearm.
Masters thesis, Universiti Sains Malaysia.
Abstract
Introduction
Open fractures considered as orthopaedic emergency and need prompt wound
debridement to prevent infection. However due to unavoidable circumstances
debridement cannot be performed perform within 12 hours. Furthermore, some times
wound debridement was delayed up to more than 48 hours. The purpose of this study to
review on the outcome of diaphyseal forearm open fracture when wound debridement
was performed according different time classification
Methods
A five-year secondary data review on the outcome of diaphyseal forearm open fractures
patients admitted to our centre between 2008 and 2013. Patients with grade IIIc open
fractures were excluded. Demographic data, time of debridement, present of infection and
type of union were recorded.
Results
We had 26 cases of open fracture diaphyseal forearm with 10 cases Grade I, seven cases
Grade II, 8 cases Grade IIIa and 1 case Grade IIIb. There was one non union with no soft
tissue infection or osteomyelitis among patients with wound debridement done before 12
hours of injury. One soft tissue infection without osteomyelitis cases and one non union
case among patients with wound debridement done with 13-24 hours of injury. There was
one soft tissue infection with osteomyelitis case and one non union case among patients
who had debridement after 24 hours of injury.
Conclusion
There was a proportionate higher risk of infection if wound debridement was delayed
more than 12 hours. Osteomyelitis was proportionately higher if wound debridement was
done after 24 hours of injury. Non union was proportionately similar if wound
debridement was done before 12 hours, within 13-24 or after 24 hours of injury.
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