Retrospective Study
Copyright ©The Author(s) 2021. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Orthop. Jul 18, 2021; 12(7): 495-504
Published online Jul 18, 2021. doi: 10.5312/wjo.v12.i7.495
Strategies and outcomes in severe open tibial shaft fractures at a major trauma center: A large retrospective case-series
Kavi H Patel, Karl Logan, Matija Krkovic
Kavi H Patel, Karl Logan, Matija Krkovic, Department of Trauma & Orthopaedics, Cambridge University Hospitals NHS Trust, Cambridge CB2 0QQ, United Kingdom
Author contributions: Patel K performed the data collection, analysis and writing the paper; Logan K performed the data collection and analysis; Krkovic M edited the manuscript; all authors read and reviewed the final manuscript.
Institutional review board statement: This study was reviewed and approved by the Cambridge University Hospital NHS Trust. No patients were involved or contacted in this study as data was derived from an electronic hospital database.
Informed consent statement: Informed consent is not required.
Conflict-of-interest statement: The authors declare that they have no conflict of interest and no funding was received for this study.
Data sharing statement: No consent for data sharing was given as all data was anonymized and there is no risk of identification.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:
Corresponding author: Kavi H Patel, MBBS, MSc, Doctor, Department of Trauma & Orthopaedics, Cambridge University Hospitals NHS Trust, Hills Road, Cambridge CB2 0QQ, United Kingdom.
Received: February 9, 2021
Peer-review started: February 9, 2021
First decision: May 3, 2021
Revised: May 16, 2021
Accepted: June 3, 2021
Article in press: June 3, 2021
Published online: July 18, 2021
Core Tip

Core Tip: Our aim was to provide an overview of the largest single-center experience in the literature, with minimum 1-year follow-up, of adult type 3 open tibial shaft fractures at Cambridge University Hospitals (a United Kingdom major trauma center). Meticulous and aggressive debridement of GA type 3 open tibia wounds by experienced orthopaedic and plastic surgeons is paramount. Grade 1 to 3A injuries can effectively be treated with reamed or unreamed intramedullary nailing. Grade 3B/C injuries are best treated by circular external fixators as they provide good if not superior outcomes to other limb salvage techniques and allow large bone defects to be addressed via distraction osteogenesis. In addition, Taylor spatial frame offers the advantages of postoperative adjustability.