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Case report: treatment of open femoral shaft fracture in a severely burned patient.

Chang TL, Spence RJ, Mears SC - Eplasty (2008)

Bottom Line: The patient was treated with intubation, intravenous antibiotics, and debridement and intramedullary nailing for the femur fracture.The patient was returned to full weightbearing and good function with a fully healed femur.Treatment of open fractures in burn patients should be tailored to the specific needs of the individual; they should be reduced and stabilized via internal fixation at the earliest opportunity and should be managed by minimizing wound colonization through successive debridement, wound care, and consideration of flap coverage.

View Article: PubMed Central - PubMed

Affiliation: Department of Orthopaedic Surgery, Johns Hopkins University/Johns Hopkins Bayview Medical Center, Baltimore, MD, USA.

ABSTRACT

Objective: To present a case report of a patient with an open fracture and severe burns and review the literature.

Methods: The patient was treated with intubation, intravenous antibiotics, and debridement and intramedullary nailing for the femur fracture. He later underwent multiple burn excision procedures with allograft and autograft skin coverage. The wound over the fracture was treated with dressing changes. The fracture was treated with nail exchange and bone grafting for atrophic nonunion.

Results: The patient was returned to full weightbearing and good function with a fully healed femur.

Conclusions: Treatment of open fractures in burn patients should be tailored to the specific needs of the individual; they should be reduced and stabilized via internal fixation at the earliest opportunity and should be managed by minimizing wound colonization through successive debridement, wound care, and consideration of flap coverage.

No MeSH data available.


Related in: MedlinePlus

Lateral radiograph of the right femur shows a type IIIB open fracture. Note the soft tissue burn injuries adjacent to the fracture.
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Figure 1: Lateral radiograph of the right femur shows a type IIIB open fracture. Note the soft tissue burn injuries adjacent to the fracture.

Mentions: In August 2003, a 43-year-old man presented to the emergency department with severe burns and a grossly deformed and bleeding right thigh after a motorcycle collision. He had become trapped under the motorcycle, which caught on fire. The patient was intubated after arrival for smoke inhalation injury. Physical examination revealed a small puncture wound laterally and 2 puncture wounds anteriorly in the midthigh, the larger of which was approximately 5 mm in diameter. The patient had a 40% total body surface area burn, all of which was deep dermal and full-thickness (“third-degree”) burn with the exception of his face, which was superficial. The fracture was within the burned area. Palpable pulses were present distally, but motor and sensory examinations could not be obtained. Anteroposterior and lateral (Fig 1) radiographs revealed a right femoral shaft fracture.


Case report: treatment of open femoral shaft fracture in a severely burned patient.

Chang TL, Spence RJ, Mears SC - Eplasty (2008)

Lateral radiograph of the right femur shows a type IIIB open fracture. Note the soft tissue burn injuries adjacent to the fracture.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC2289779&req=5

Figure 1: Lateral radiograph of the right femur shows a type IIIB open fracture. Note the soft tissue burn injuries adjacent to the fracture.
Mentions: In August 2003, a 43-year-old man presented to the emergency department with severe burns and a grossly deformed and bleeding right thigh after a motorcycle collision. He had become trapped under the motorcycle, which caught on fire. The patient was intubated after arrival for smoke inhalation injury. Physical examination revealed a small puncture wound laterally and 2 puncture wounds anteriorly in the midthigh, the larger of which was approximately 5 mm in diameter. The patient had a 40% total body surface area burn, all of which was deep dermal and full-thickness (“third-degree”) burn with the exception of his face, which was superficial. The fracture was within the burned area. Palpable pulses were present distally, but motor and sensory examinations could not be obtained. Anteroposterior and lateral (Fig 1) radiographs revealed a right femoral shaft fracture.

Bottom Line: The patient was treated with intubation, intravenous antibiotics, and debridement and intramedullary nailing for the femur fracture.The patient was returned to full weightbearing and good function with a fully healed femur.Treatment of open fractures in burn patients should be tailored to the specific needs of the individual; they should be reduced and stabilized via internal fixation at the earliest opportunity and should be managed by minimizing wound colonization through successive debridement, wound care, and consideration of flap coverage.

View Article: PubMed Central - PubMed

Affiliation: Department of Orthopaedic Surgery, Johns Hopkins University/Johns Hopkins Bayview Medical Center, Baltimore, MD, USA.

ABSTRACT

Objective: To present a case report of a patient with an open fracture and severe burns and review the literature.

Methods: The patient was treated with intubation, intravenous antibiotics, and debridement and intramedullary nailing for the femur fracture. He later underwent multiple burn excision procedures with allograft and autograft skin coverage. The wound over the fracture was treated with dressing changes. The fracture was treated with nail exchange and bone grafting for atrophic nonunion.

Results: The patient was returned to full weightbearing and good function with a fully healed femur.

Conclusions: Treatment of open fractures in burn patients should be tailored to the specific needs of the individual; they should be reduced and stabilized via internal fixation at the earliest opportunity and should be managed by minimizing wound colonization through successive debridement, wound care, and consideration of flap coverage.

No MeSH data available.


Related in: MedlinePlus