FIX AND FLAP : A RADICAL ORTHOPAEDIC AND PLASTIC TREATMENT OF SEVERE OPEN INJURIES OF THE FOOT
Abinesh Srinivasan
, DR KORNAD KOSYGAN
FIX AND FLAP, OPEN INJURIES, GUSTILLI ANDERSON TYPE III, INTERNAL FIXATION
AIM :
TO STUDY THE OUTCOME OF AGGRESSIVE COMBINED ORTHOPAEDIC AND PLASTIC SURGICAL INTERVENTION IN GUSTILLO IIIA, AND IIIB OPEN INJURIES BY FRACTURE STABILISATION WITH INTERNAL FIXATION(PLATES AND SCREWS) AND FLAP COVER WITHIN 72 HOURS OF PRESENTATION
MATERIALS AND METHODS ;
A RETROSPECTIVE CASE STUDY OF TOTAL OF 5 PATIENTS (7 FOOT) WHO HAD SUFFERED CRUSH INJURY - ROAD TRAFFIC INJURY IN THE PERIOD OF MARCH TO NOVEMBER 2024. ALL HAD BEEN TREATED WITH RADICAL PROTOCOL WHICH INCLUDED EARLY DEBRIDEMENT, FRACTURE FIXATION AND SOFT TISSUE COVER WITH MUSCLE FLAP BY A COMBINED ORTHOPAEDIC AND PLASTIC SURGERY. OUR IDEAL MANAGEMENT IS RADICAL DEBRIDEMENT OF THE WOUND OUTSIDE THE ZONE OF INJURY, SKELETAL STABILISATION BY INTERNAL AND SOFT TISSUE COVER WITH VASCULARISED MUSCLE FLAP.
RESULTS :
IN 7 FOOT, 2 PEDICLE FLAP WERE USED AND 5 MYOCUTANEOUS FREE FLAP. STABILISATION OF FRACTURE WAS ACHIEVED WITH 9 INTERNAL FIXATION DEVICES AND 4 EXTERNAL FIXATION DEVICES. ALL PATIENTS HAD FORMATION OF CALLUS AFTER 6 WEEKS OF POSTOP RADIOGRAPHS AND THERE WAS NO NON UNION, FLAP FAILURE. DEEP INFECTION WAS SEEN IN 14%, AND SUPERFICIAL INFECTION ON 28%. AT THE END OF FINAL FOLLOWUP ALL PATIENTS WERE WALKING FREELY ON UNITED FRACTURES WITH NO EVIDENCE OF INFECTION
CONCLUSION :
THE TREATMENT OF THESE VERY SEVERE INJURIES BY AN AGGRESSIVE COMBINED ORTHOPAEDIC AND PLASTIC ( MICROVASCULAR SURGEON) PROVIDES GOOD RESULT, IMMEDIATE INTERNAL FIXATION WITH ADEQUATE DEBRIDEMENT AND HEALTHY SOFT TISSUE COVER WITH A MUSCLE FLAP IS SAFE. EXTERNAL FIXATION WAS ASSOCIATED WITH PRACTICAL DIFFICULTIES AND PIN TRACT INFECTIONS.HENCE WE PREFER INTERNAL FIXATION WITH FLAP.
"FIX AND FLAP : A RADICAL ORTHOPAEDIC AND PLASTIC TREATMENT OF SEVERE OPEN INJURIES OF THE FOOT", JETNR - JOURNAL OF EMERGING TRENDS AND NOVEL RESEARCH (www.JETNR.org), ISSN:2984-9276, Vol.4, Issue 4, page no.a45-a55, April-2026, Available :https://rjpn.org/JETNR/papers/JETNR2604007.pdf
Volume 4
Issue 4,
April-2026
Pages : a45-a55
Paper Reg. ID: JETNR_232607
Published Paper Id: JETNR2604007
Downloads: 00058
Research Area: Humanities All
Country: Trichy, Tamil Nadu, India
ISSN: 2984-9276 | IMPACT FACTOR: 9.87 Calculated By Google Scholar | ESTD YEAR: 2023
An International Scholarly Open Access Journal, Peer-Reviewed, Refereed Journal Impact Factor 9.87 Calculate by Google Scholar and Semantic Scholar | AI-Powered Research Tool, Multidisciplinary, Monthly, Multilanguage Journal Indexing in All Major Database & Metadata, Citation Generator
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