Time Management of Open Lower-Leg Fractures in Morocco

• 作者: Abderrahmane Maaroufi Adonis Magoumou Fatima Zahra Widad Mohamed Nechad Mohamed Ouarab Mustapha Fadili Othmane Hiba Samira Hassoune Samira Nani Simohamed Fahsi Yassir El Andaloussi
• 来源期刊: 急诊医学(英文)
• 学科: 医学
• 关键词: OPEN FRACTURE Lower-Leg FRACTURE Chu Ibn Rochd Casablanca
• 年，卷（期）: 2014,（3）
• 页码范围: 53-61
• 页数: 9页
• 分类号: R73

摘要

Background: It is recommended that the management of open lower-leg fractures should occur within six hours to avoid complications affecting both prognosis and functionality. This study aimed to evaluate the time taken for each step of management, identify causes of delay, and propose solutions to reduce the rate of complications. Patients and methods: This was a prospective study involving 153 patients treated from January 2011 to December 2012. Standardized data collection forms documented the times taken for each management step from the accident until surgical intervention. Results: For patients admitted directly to our institution, median time to surgical debridement from arrival was 5 hours. Median time for bone fixation was 24 hours. External fixation was used in 119 patients. There were several causes of delay;lack of financial resources was the most common. Certain causes of delay were significantly correlated with time to debridement. However, although 86.7% of patients who developed an infection had a time from injury to debridement greater than six hours, there was no statistically significant association between infection and delay beyond six hours (p = 0.403). Conclusion: By identifying causes of treatment delay, we hope to be able to avoid complications, and therefore reduce the socio- economic impact of these important surgical emergencies.