O2115 MANAGEMENT OF FRACTURES OF THE UPPER LIMB WITH ASSOCIATED SOFT TISSUE INVOLVEMENT

Abstract

Aim of Study: The clinical and radiological assessment of the results of the operative treatment of fractures of the upper limb with associated soft tissue involvement. Methods: We present a review of 17 patients with fractures, nonunions, pseudarthroses and malunions of the forearm (8) and hand (9) with associated soft tissue involvement. All cases were chronic injuries. Three female and 14 male with average age of 27 (12–43) were operated between 9/1998 and 3/2002. The average time before surgery was 10 months. The causes of the defects were severe trauma in 10 cases, electric injuries in 2, osteomyelitis in 3 and combustion in 2 cases. At follow-up the patients were evaluated for bone unuon, ßap integration, function (AROM, grafting power), complications. In 13 patients we performed an open reduction and internal þxation (ORIF) with Pi-, LC DCP, T-plates; in 4 Ð an external þxation (AO-þxator). The osteosynthesis was accompanied with free ßaps transfer (2), pedicled ßaps (8), free nonvascularized bone grafts (3), local skin ßaps and skin grafting (7). Results: The good and excellent results (bone union, ßap integration) were received in 78% of patients, who we performed the transposition of the pedicled ßaps, in a combination with stabile þxation (ORIF); satisfactory Ð in 22%. We observed the following complications: partial necrosis of ßap (3), and bone graft (2), refracture (1). Conclusions: The combination of stabile þxation of bone fragments and adequate coverage of the soft tissue defects is an efþcient method in the treatment of bone fractures with soft tissue involvement. This combination creates an optimal condition for early rehabilitation and improves results of treatment.