Open tibia fractures in the splenectomized trauma patient: Results of treatment with locking, intramedullary fixation

W. I. Sterett, Janos Ertl, M. W. Chapman, H. D. Moehring

Research output: Contribution to journalArticle

5 Citations (Scopus)

Abstract

Objective: To confirm our clinical impression that patients with traumatic splenectomy had more complications in the treatment of open tibia fractures, we retrospectively reviewed the records of patients with open tibia fractures treated between 1989 and 1992. Materials and methods: Eight patients with open tibia fractures and traumatic splenectomies were compared to 43 patients with open tibia fractures and intact spleens. The latter group typically underwent either exploratory laparotomy or peritoneal lavage. The two groups were similar with respect to age, mechanism of injury, fracture wound classification, and injury severity score (22.4 in the splenectomized patients, 18.6 in the control). All tibia fractures were treated with a nonreamed, crosslocked, titanium intramedullary nail, and all patients were treated according to the same protocol of antibiotic therapy. Patients were followed for two years or until roentgenographic and clinical union. Results: The splenectomized patients had a significantly higher incidence of chronic osteomyelitis (25% vs. 4.6%), and the need for additional tibial surgeries to achieve union (75% vs. 16%). Time to union averaged 11.3 months in the splenectomized group and 7.6 months in the patients with intact spleens. Conclusions: The increased risk for chronic osteomyelitis and other complications of tibial fracture in the splenectomized patients should be taken as an argument favoring splenic repair, when possible, rather than splenectomy in victims of blunt multiple trauma.

Original languageEnglish (US)
Pages (from-to)639-641
Number of pages3
JournalJournal of Trauma - Injury, Infection and Critical Care
Volume38
Issue number4
StatePublished - 1995
Externally publishedYes

Fingerprint

Open Fractures
Tibia
Wounds and Injuries
Splenectomy
Therapeutics
Osteomyelitis
Spleen
Peritoneal Lavage
Tibial Fractures
Injury Severity Score
Multiple Trauma
Nails
Titanium
Laparotomy
Anti-Bacterial Agents

Keywords

  • infection
  • nonunion
  • spleen
  • tibia fracture

ASJC Scopus subject areas

  • Surgery

Cite this

Open tibia fractures in the splenectomized trauma patient : Results of treatment with locking, intramedullary fixation. / Sterett, W. I.; Ertl, Janos; Chapman, M. W.; Moehring, H. D.

In: Journal of Trauma - Injury, Infection and Critical Care, Vol. 38, No. 4, 1995, p. 639-641.

Research output: Contribution to journalArticle

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