Incidencia de sepsis y principales complicaciones de fracturas expuestas de huesos largos en la población pediátrica

Luis Diego Castro Sánchez; Diana Hernández Víquez; Gary Sanabria Ávila; Jorge Alpizar Arias

2013, Number 608

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Rev Med Cos Cen 2013; 70 (608)

Incidencia de sepsis y principales complicaciones de fracturas expuestas de huesos largos en la población pediátrica

Castro SLD, Hernández VD, Sanabria ÁG, Alpizar AJ

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Language: Spanish
References: 26
Page: 721-729
PDF size: 431.03 Kb.

ABSTRACT

Open fractures are considerated an emergency. This study describes the incidence rate of infection and main complications of these kind of fractures, attended in the Costa Rica National Children´s Hospital, between January 1st of 2009 and December 31st of 2011, with a minimal follow of 17 months. 46 patients were attended, 36 males and 10 females. The average age was 9 and the main affected bone was the left ulna. The rate of infection was 4.32% of the cases (2 children). The most common type of fracture according to the Gustillo and Anderson's classification for open fractures, was the type I. Thirty eight patients didn´t have any complication, but 10 did. The main complications were the compartimental syndrome, non union and the nerve injuries (2 cases each). Staphilococcus aureus bacteria were found in one patient that developed infection.

REFERENCES

Browner, B.; Levine, A.; Jupiter, J.; Sirkin, M. Fractures, Dislocations, Ligamentous Injuries. Skeletal Trauma , 2nd Edition. Philadelphia, WB Saunders, 1998, p. 419-448.
2) Calder, PR; Reidy J.; Crone D.; Paterson, JMH, Barry, M. Open Fractures in Children: A five year review. J. Bone Joint Surg (BR) 2005; 87-B, Supp III, p. 394.
3) Capo, J; Hall, M.; Nourbakhsh, A; Tan, V. Initial Management of Open Hand Fractures in an Emergency Department. Am J Orthop. 2011; 40 (12), p 243-248.
4) Cullen, Mark C.; Roy, Dennis R.; Crawford, Alvin H. Assenmacher, Joseph; Levy, Martin S.; Wen, Daling. Open Fracture of the Tibia in Children. The Journal of Bone and Joint Surgery, Incorporated, Volume 78-A, Number 7, July 1996, p 1039- 10499.
5) Doak, Jeremy; Ferrick, Michael. Nonoperative Management of Pediatric Grade 1 Open Fractures With Less Than a 24 Hour Admission. Pediatr Orthop, Volume 29, Number 1, January/February 2009, p 49-51.
6) Evans, Andrew R.; Agel, Julie. A New Classification Scheme for Open Fractures. J Orthop Trauma, June 2010, p 457-463.
7) Greenbaum, Bradley; Zionts, Lewis E.; Ebramzadeh, Edward. Open Fractures of the Forearm in Children. The Journal of Orthopaedic Trauma, Volume 15, Number 2, 2001, p 111-118.
8) Gustillo, Ramon B.; Anderson, John T. Prevention of Infection in the Treatment of One Thousand and Twenty-Five Open Fractures of Long Bones. The JBJS, Volume 58- A, Number 4, June 1976, p 682.
Haasbeek, Jeffrey F.; Cole, William G. Open Fractures of the Arm in Children. The Journal of Bone and Joint Surgery-British Volume 77-B (4), July 1995, p 576-581.
Harley, Brian J.; Beaupre, Lauren A.; Jones, C. Allyson; Dulai, Sukhdeep K.; Weber, Donald W. The Effect of Time to definitive Treatment on the Rate of Nonunion and Infection in Open Fractures. J. Orthop Trauma, Volume 16, Number 7, 2002, p 484- 490.
11) Iobst, Christopher A.; Tidwell, Michael A.; King, Wesley F. Nonoperative Management of Pediatric Type I Open Fractures. Pediatr Orthop, Volume 25, Number 4, July/August 2005, p 513-517.
Lee Pace, James; Kocher, Mininder S.; Skaggs, David L. Evidencebased Review: Management of Open Pediatric Fractures. Pediatr Orthop, Volume 32, Number 2, Supplement, September 2012, p 123-127.
Lim, Yi-Jia; Lam, Khee Sien; Lee, Eng Hin. Open Gustilo 1 and 2 Midshaft Fractures of the Radius and Ulna in Children. Pediatr Orthop, Volume 27, Number 5, July/August 2007, p 540-546.
McCarthy, James J.; Dormans, John P.; Kozin, Scott H.; Pizzutillo, Peter D. Musculoskeletal Infections in Children. The Journal of Bone & Joint Surgery – JBJS. ORG, Volume 86-A, Number 4, April 2004, p 850- 861.
Okike, Kanu; Bhattacharyya, Timothy. Current Concepts Review. Trends in the Management of Open Fractures. A critical analysis. The Journal of Bone & Joint Surgery – JBJS.ORG, Volume 88-A, Number 12, December 2006, p 2739-2748.
16) Rambani, R.; Sharma, H.; Sood, A. Validity of six hour rule un Grade 3 open fractures. The Journal of Bone & Joint Surgery – JBJS.ORG, 2010; 92-B; SUPP IV, p 557.
Ramseier, Leonhard Erich; Bhaskar, Atul R.; Cole, William G.; Howard, Andrew E. Treatment of Open Femur Fractures in Children. Comparison Between External Fixator and Intramedullary Nailing. Pediatr Orthop, Volume 27, Number 7, October/November 2007, p 748- 750.
Robertson, Patrick; Karol, Lori A.; Rab, George T. Open Fractures of the Tibia and Femur in Children. Journal of Pediatric Orthopaedics, Volume 16 (5), September/October 1996, p 621-626.
Ruiz, B.; Campos, J.; Franco, E.; Suárez, A. Manual Amir de Infecciones y Microbiología. 5ta Ed. Editorial Marbán, España, 2012, p 40-42.
Schenker, Mara L.; Yannascoli, Sarah; Baldwin, Keith D.; Ahn, Jaimo; Mehta, Samir. Does Timing to Operative Debridement Affect Infectious Complications in Open Long-Bone Fractures?. The Journal of Bone & Joint Surgery – JBJS. ORG Volume 94-A, Number 12, June 20, 2012, p 1057-1064.
Schmauch, M. Open Fractures in Children: A Revision of 274 Patients with 281 Open Fractures. The Journal of Bone and Joint Surgery- British Volume 82-B, Supplement II, 2000, p 111-112.
Skaggs, David L.; Friend, Lauren; Alman, Benjamin; Chambers, Henry G.; Schmitz, Michael; Leake, Brett; Kay, Robert M.; Flynn, John M. The Effect of Surgical Delay on Acute Infection Following 554 Open Fractures in Children. The Journal of Bone & Joint Surgery – JBJS.ORG, Volume 87-A, Number 1, January 2005, p 8-12.
2Stannard, James P.; Volgas, David A.; Stewart, Rena, McGwin, Gerald; Alonso, Jorge E. Negative Pressure Wound Therapy After Severe Open Fractures: A Prospective Randomized Study. Orthop Trauma, Volume 23, Number 8, September 2009, p 552-557.
Stewart, David G.Jr.; Kay, Robert H.; Skaggs, David L. Current Concepts Review. Open Fractures in Children. The Journal of Bone & Joint Surgery – JBJS.ORG, Volume 87-A, Number 12, December 2005, p 2784- 2798.
Véesei, V.; Greitbauer, M. Open Fractures: Classification and Principles of Management. The Journal of Bone and Joint Surgery- British Volume 84-B, Supplement II, 2002, p 115.
Zalavras, Charalampos G.; Marcus, Randall E.; Levin, Scott; Patzakis, Michael J. Management of Open Fractures and Subsequent Complications. The Journal of Bone and Joint Surgery, April 01, 2007, p 884-895.