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Open fractures of the calcaneus : Soft-tissue injury determines outcome
HEIER KA; INFANTE AF; WALLING A
J BONE JOINT SURG AM , 2003, vol. 85, n° 12, p. 2276-2282 Doc n°: 112070 Localisation : Bibliothèque Universitaire de Médecine de Nancy Descripteurs : DE841 - FRACTURE DU CALCANEUS Studies of open calcaneal fractures have been limited and have not analyzed results according to wound location, severity of soft-tissue disruption, fracture type, or treatment method. In this study, results were evaluated on the basis of the hypothesis that early surgical intervention was indicated. Methods: Between 1989 and 1997, 503 calcaneal fractures were treated at our institution, and forty-three of these fractures, in forty-two patients, were open (8.5%). According to the Gustilo classification there were nine typed, eight type-II, twelve type-IIIA, and thirteen type-IIIB open fractures as well as one type-IIIC open fracture. All fractures were treated according to the same protocol, consisting of intravenous administration of antibiotics chosen on the basis of the wound type, irrigation and debridement in the operating room, temporary wound coverage, and initial stabilization of the limb. Definitive final fixation was performed after the wound was clean, and soft-tissue swelling was minimal. Langue : ANGLAIS |
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