Authors: Sabo Vy, Abubakar Ai, Kolo N, Garba B
KEYWORDS: Open fractures tibia, soft tissues, Orthoplastic
Abstract
Introduction: Open fractures of the tibia result from high-energy impact and are associated with soft tissue injuries and contamination. This article aims to serve as a surgical audit tool that will influence a modification in how the soft tissue injuries associated with open fractures of the tibia should be evaluated and managed.
Methodology: this was a hospital-based retrospective study carried out at a tertiary healthcare facility involving open fractures of the tibia managed at a teaching hospital over three years from January 2019 to December 2021. Variables collected from patients’ records for this study were: gender, age at presentation, the time between injury and presentation, type and location of the open fracture of the tibia, initial care administered, and soft tissue care and were presented appropriately as frequencies and percentages, tables & charts and mean and standard deviations for continuous variables.
Results: Twenty (20) patients with open fractures of the tibia were admitted into the accident and emergency unit during the study period. The majority of these patients (70%) were between the ages of 21 and 40 years, and 75% were males. RTA was the aetiologic agent in 90% of patients while Gunshot wound was the cause in 10%. The average time spent by the patient from injury to presentation was 4.8 hours (SD± 2.2) with 70% of patients presenting within six (6) hours of the injury. Gustillo-Anderson type III injury was seen in 50% of patients (50% had type IIIA while only 20% had type IIIC injuries. Only three out of the eight patients (37.5%) were reviewed by Plastic Surgery for their soft tissue injury when consult was received after six days of hospital admission; 60% of patients presenting with open fracture of the tibia signed and left against medical advice (SAMA)
Conclusion: Open fracture of the tibia affects predominantly the young productive individuals of the male gender. These open fractures are of the severe categories with soft tissue involvement whose reconstructive requirements will require early and prompt input from the Plastic Surgeon. The benefits of the early presentation can be harnessed through a joint review and treatment plan by the Orthopaedic and Plastic surgery specialties in other to achieve excellent outcomes.