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Objective: To compare the rate of infection, knee range of motion and union in early versus delayed fixation of Gustilo and Anderson open type III A fracture of distal femur after initial debridement.
Study Design: A randomized controlled trial.
Place and Duration: Department of Orthopedic Surgery, Lahore General Hospital, Lahore from 1st September 2018 to 30th August 2019.
Methodology: A total of 70 patients of both genders aged 20 to 60 years with Gustilo Anderson open type III-A fracture were enrolled. After randomization, for patients in Group-A (n=35), fracture fixation was done within 72 hours of trauma (early fixation) while in Group-B (n=35), delayed fixation was done (fracture fixation after 72 hours of trauma). All patients underwent open reduction and internal fixation with dynamic condylar screw. Patients were periodically followed up to see the infection, knee range of motion and union.
Results: In a total of 70 patients, mean age was 35.81±11.31 years (ranging 18 to 58 years). In Group-A, duration of hospital stay was significantly less in comparison to patient in Group-B (7.60+2.26 vs. 15.85+6.33, p<0.0001). Overall infection rate was higher in Group-B as compared to Group-A till 8th week (p<0.05). Union was statistically different in both treatment groups from 8th week till 24th week follow up (p<0.05). It was observed that mean flexion was high in Group-A patients as compared to that of Group-B patients.
Conclusions: Early open reduction and internal fixation of open type IIIA fracture of distal femur is better than delayed open reduction and internal fixation after initial debridement in terms of infection, knee range of motion and union.
Keywords: Debridement, Femur, Fracture fixation, Knee, Infection, Range of motion.
How to Cite This:
Hussain R, Basit MA, Ijaz A, Shakeel M, Jalal SF, Hanif MM. Comparison of early versus delayed fixation after debridement of Open Type III-A Fracture of distal Femur: A Randomized Controlled Trial. Isra Med J. 2021; 13(3): 167-171.
Muhammad Abdul Basit, Rashid Hussain, Amoluk Ijaz, Muhammad Shakeel, Sayed Farooq Jalal, Mian Muahmmad Hanif. (2021) Comparison of early versus delayed fixation after debridement of Open Type III-A Fracture of distal Femur: A Randomized Controlled Trial, Isra Medical Journal, Volume 13, Issue 03.
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