Le fratture esposte articolari e periarticolari
Abstract
ARTICULAR AND PERIARTICULAR OPEN FRACTURES
Exposed articular and periarticular fractures are serious injuries, often resulting from high-energy traumas,
associated to high risk of septic complications, functional impairment of the affected limb and not infrequently
patient’s life threatening conditions. Their incidence, though low, is however increasing.
The patient with exposed fracture presents an associated injury up to one third of cases. The initial evaluation plays a
fundamental role both in the identification and treatment of any concomitant injuries, and in the choice of strategy
and timing of treatment of the exposed fractures. The presence of a plastic surgeon in the team facilitates the
definition of the therapeutic path.
The debridement of the lesion is a fundamental time and must be accurate. Stabilization with external fixator is
certainly the treatment of choice and can be adopted both as temporary or as a definitive fixation. Soft tissue
management is the keystone of the therapeutic pathway of exposed articular and periarticular fractures. The progress
made in “orthoplasty” encourages acute internal fixation and immediate coverage—fix and flap, with a significant
reduction in infectious risks and improvement of prognosis.
In any case, the available evidence about the treatment of these injuries is limited. Proper management requires a
multidisciplinary approach, great experience and personalization of the therapeutic path.
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This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
Copyright
© Società Italiana Ortopedici Traumatologi Ospedalieri d’Italia 2019 , 2019
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