Key result
Small bone defects in open femoral fractures can be managed with standard fixation and autogenous bone grafting, while larger defects may require shortening and later lengthening.
Why the study?
Deciding whether to perform limb reconstruction or primary amputation in cases of critical bone loss is clinically difficult, prompting an evaluation of treatment options and complications for open femoral fractures with bone loss.
This review highlights that small bone defects in open femoral fractures are manageable with standard fixation and grafting, whereas larger defects require more complex staged reconstruction.
Background: Attempting limb reconstruction in the presence of critical bone loss usually involves surgery which had technically difficult, time-consuming, physically, and psychologically demanding for the case, with no guarantee of a satisfactory outcome. The function of the salvaged limb might be disappointing due to residual pain, joint stiffness, and neurovascular deficit. The case might require a secondary amputation due to refractory disease or non-union. Thus, the correct initial decision as to whether to embark upon limb reconstruction or to perform a primary amputation had important but difficult. Objective: The aim of this essay had to evaluate various treatment options for open femoral fracture with bone loss regarding, different methods to compensate for bone loss, and the complications of each one. Methods: PubMed, Google Scholar, and Science Direct were searched using the following keywords: Treatment of open femoral fracture, Bone loss, and Bone loss and complications. The authors also screened references from the relevant literature, including all the identified studies and reviews, only the most recent or complete study was included between June 2000 and December 2020. Documents in a language apart from English have been excluded as sources for interpretation were not found. Papers apart from main scientific studies had been excluded: documents unavailable as total written text, conversation, conference abstract papers, and dissertations. Conclusion: Bone loss had a relatively uncommon problem encountered in the treatment of open fractures, and usually occurs in the femur and tibia. The majority of defects had small and could be managed with standard methods of fixation, and autogenous bone grafting. Larger defects with complex soft-tissue problems could be managed by shortening, fixation with later lengthening.
No takes yet. Share an insight, caveat, or question.
Mohamed et al. (2022) conducted a review in Open femoral fracture with bone loss. Limb reconstruction techniques (fixation, bone grafting, shortening with later lengthening) was evaluated. Small bone defects in open femoral fractures can be managed with standard fixation and autogenous bone grafting, while larger defects may require shortening and later lengthening.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: