Emergency Intramedullary Nailing in Open Leg Fractures: What Results?

Abstract

Introduction: Leg fractures are the prerogative of violent trauma, which lead to pluritissular lesions, including the opening of the focus, thus worsening the prognosis. The indication of centromedullary nailing (CMN) is subject to time and trained team requirements. The aim of this work is to evaluate the results of CMN in emergency cases of open leg fractures in adults. Patients and Methods: This was a retrospective, descriptive and analytical study from January 1, 2014 to December 31, 2018. It concerned adult patients with an open leg fracture treated by CMN in emergency at the Orthopedics-Traumatology Department of the Yalgado Ouedraogo University Hospital. During five years, 91 patients were registered. Their average age was 34.1 years with a sex ratio of 2.2. The average admission time was 1 hour 41 minutes. Cauchoix and Duparc type I open fractures predominated (64.8%). Antibiotic therapy was instituted as soon as the patient arrived. The functional results of osteosynthesis were evaluated according to the Lysholm score after an average follow-up of 48 months. Results: The majority of our patients (51.3%) were operated on between the 6th and 18th hour. After careful trimming of the open fracture, CMN was performed in all our patients. The average hospital stay was six days. The mean Lysholm score was 87.23 ± 11.06 with a satisfactory functional result in 81.3% of cases. Discussion: The satisfactory results observed in 81.3% of our study testify to the reliability of the indication of CMN as specified by Dakouré et al. [4] in their series. Conclusion: Open leg fractures are very frequent injuries and have a considerable socio-economic impact. Centromedullary nailing is a suitable solution for adequate and rapid socio-professional reintegration of the patient.