Long Bone Fractures & Extremity Compart. Syndrome - The Eastern Association for the Surgery of Trauma

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Eastern Association for the Surgery of Trauma

Long Bone Fractures & Extremity Compart. Syndrome

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Surgical vs nonsurgical treatment of adults with displaced fractures of the proximal humerus: the PROFHER randomized clinical trial.

Rangan A, Handoll H, Brealey S, Jefferson L, Keding A, Martin BC, Goodchild L, Chuang LH, Hewitt C, Torgerson D; PROFHER Trial Collaborators.

JAMA. 2015 Mar 10;313(10):1037-47.

Rationale for inclusion: This prospective, multi-center, randomized trial compared fracture fixation or humeral head replacement to the nonsurgical treatment of proximal humeral fractures at the surgical neck, finding no difference in clinical outcomes at two years and supporting nonoperative management including sling immobilization for these patients.

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Nonunion of the femoral diaphysis. The influence of reaming and non-steroidal anti-inflammatory drugs.

Giannoudis PV, MacDonald DA, Matthews SJ, Smith RM, Furlong AJ, De Boer P.

J Bone Joint Surg Br. 2000 Jul;82(5):655-8.

Rationale for inclusion: This study identified the association of NSAID use with nonunion of femoral fractures, noting delayed healing in these patients and recommending against the use of NSAIDs in this patient population.

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External fixation as a bridge to intramedullary nailing for patients with multiple injuries and with femur fractures: damage control orthopedics.

Scalea TM, Boswell SA, Scott JD, Mitchell KA, Kramer ME, Pollak AN.

J Trauma. 2000 Apr;48(4):613-21; discussion 621-3.

Rationale for inclusion: This retrospective analysis of 43 patients undergoing initial external fixation for stabilization of femur fractures as compared to 284 patients undergoing primary and definitive intramedullary nailing proved the safety of temporary fixation for management of multi-trauma patients with femur fractures.

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Compartment monitoring in tibial fractures. The pressure threshold for decompression.

McQueen MM, Court-Brown CM.

J Bone Joint Surg Br. 1996 Jan;78(1):99-104.

Rationale for inclusion: Utilizing a series of 116 patients with tibial fractures, this paper identified a 2.6% incidence in acute compartment syndrome. They identified that differential pressure (diastolic pressure minus compartment pressure) of 30 mmHg served as a more reliable predictor of need for fasciotomy as compared to absolute compartment pressures of either 30 or 40mmHg.

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Early versus delayed stabilization of femoral fractures. A prospective randomized study.

Bone LB, Johnson KD, Weigelt J, Scheinberg R.

J Bone Joint Surg Am. 1989 Mar;71(3):336-40.

Rationale for inclusion: Using 178 patients with acute femoral fractures, this study identified increased pulmonary complications, cost, and hospital stay when delayed intervention was performed as compared to those undergoing early stabilization.

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The tibial plateau fracture. The Toronto experience 1968--1975.

Schatzker J, McBroom R, Bruce D.

Clin Orthop Relat Res. 1979 Jan-Feb;(138):94-104.

Rationale for inclusion: This series of 94 tibial plateau fractures from 1968-1975 documented an early classification system of this fracture into 6 types with introduction of type-specific recommendations for intervention.

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Prevention of infection in the treatment of one thousand and twenty-five open fractures of long bones: retrospective and prospective analyses.

Gustilo RB, Anderson JT.

J Bone Joint Surg Am. 1976 Jun;58(4):453-8.

Rationale for inclusion: This early case series from 1955-1968 describes the management of open long bone fractures, identifying a cephalosporin as appropriate antibiotic prophylaxis as well as documenting increasing infectious complications with increased severity of injury.

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