Amputation rate following tibia fractures with associated popliteal artery injuries

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dc.contributor.advisorMaqungo, Sithomboen_ZA
dc.contributor.advisorRoche, Stephenen_ZA
dc.contributor.authorRoussot, Marken_ZA
dc.date.accessioned2017-10-03T14:18:13Z
dc.date.available2017-10-03T14:18:13Z
dc.date.issued2017en_ZA
dc.description.abstractObjectives: 1. Determine the amputation rate; and 2. identify risk factors in patients with tibia fractures and associated popliteal artery injuries. Intervention: Amputation or limb salvage. Design: Retrospective case-control study. Setting: Level 1 trauma center. Patients: Thirty popliteal artery injuries with ipsilateral tibial fractures. Outcome measures: Primary and delayed amputation rates were determined. Risk factors tested for significance (Fischer's Exact) included: mechanism of injury, signs of threatened viability, compartment syndrome, fracture pattern, surgical sequence, and time delay from injury or presentation to revascularization. Results: The study group consisted of 22 males and 8 females, with a mean age of 31 years. Motor vehicle accidents and gunshot wounds constituted the mechanism in 17 and 11 patients respectively. Twenty-one were polytrauma victims. Intra/extra16 articular metaphyseal fractures (OTA 41 A-C) were recorded in 19 and diaphyseal (OTA 42 A-C) in 7 patients. Primary amputation was performed in 7 and delayed in 10 patients (overall rate 57%). No individual risk factors were predictive of amputation; however, the "miserable triad" of a proximal tibia fracture (OTA 41) with signs of threatened viability, and delay to revascularization ≥ 6 hours from injury or ≥ 2 hours from presentation was predictive of amputation (p = 0,036 and p = 0,018 respectively). Conclusions: We should aim to intervene within 6 hours following injury or 2 hours following presentation to reduce the risk of amputation. This provides a target for trauma teams even with uncertain time of injury. Level of Evidence: III.en_ZA
dc.identifier.apacitationRoussot, M. (2017). <i>Amputation rate following tibia fractures with associated popliteal artery injuries</i>. (Thesis). University of Cape Town ,Faculty of Health Sciences ,Department of Health and Rehabilitation Sciences. Retrieved from http://hdl.handle.net/11427/25507en_ZA
dc.identifier.chicagocitationRoussot, Mark. <i>"Amputation rate following tibia fractures with associated popliteal artery injuries."</i> Thesis., University of Cape Town ,Faculty of Health Sciences ,Department of Health and Rehabilitation Sciences, 2017. http://hdl.handle.net/11427/25507en_ZA
dc.identifier.citationRoussot, M. 2017. Amputation rate following tibia fractures with associated popliteal artery injuries. University of Cape Town.en_ZA
dc.identifier.ris TY - Thesis / Dissertation AU - Roussot, Mark AB - Objectives: 1. Determine the amputation rate; and 2. identify risk factors in patients with tibia fractures and associated popliteal artery injuries. Intervention: Amputation or limb salvage. Design: Retrospective case-control study. Setting: Level 1 trauma center. Patients: Thirty popliteal artery injuries with ipsilateral tibial fractures. Outcome measures: Primary and delayed amputation rates were determined. Risk factors tested for significance (Fischer's Exact) included: mechanism of injury, signs of threatened viability, compartment syndrome, fracture pattern, surgical sequence, and time delay from injury or presentation to revascularization. Results: The study group consisted of 22 males and 8 females, with a mean age of 31 years. Motor vehicle accidents and gunshot wounds constituted the mechanism in 17 and 11 patients respectively. Twenty-one were polytrauma victims. Intra/extra16 articular metaphyseal fractures (OTA 41 A-C) were recorded in 19 and diaphyseal (OTA 42 A-C) in 7 patients. Primary amputation was performed in 7 and delayed in 10 patients (overall rate 57%). No individual risk factors were predictive of amputation; however, the "miserable triad" of a proximal tibia fracture (OTA 41) with signs of threatened viability, and delay to revascularization ≥ 6 hours from injury or ≥ 2 hours from presentation was predictive of amputation (p = 0,036 and p = 0,018 respectively). Conclusions: We should aim to intervene within 6 hours following injury or 2 hours following presentation to reduce the risk of amputation. This provides a target for trauma teams even with uncertain time of injury. Level of Evidence: III. DA - 2017 DB - OpenUCT DP - University of Cape Town LK - https://open.uct.ac.za PB - University of Cape Town PY - 2017 T1 - Amputation rate following tibia fractures with associated popliteal artery injuries TI - Amputation rate following tibia fractures with associated popliteal artery injuries UR - http://hdl.handle.net/11427/25507 ER - en_ZA
dc.identifier.urihttp://hdl.handle.net/11427/25507
dc.identifier.vancouvercitationRoussot M. Amputation rate following tibia fractures with associated popliteal artery injuries. [Thesis]. University of Cape Town ,Faculty of Health Sciences ,Department of Health and Rehabilitation Sciences, 2017 [cited yyyy month dd]. Available from: http://hdl.handle.net/11427/25507en_ZA
dc.language.isoengen_ZA
dc.publisher.departmentDepartment of Health and Rehabilitation Sciencesen_ZA
dc.publisher.facultyFaculty of Health Sciencesen_ZA
dc.publisher.institutionUniversity of Cape Town
dc.subject.otherOrthopaedic Surgeryen_ZA
dc.titleAmputation rate following tibia fractures with associated popliteal artery injuriesen_ZA
dc.typeMaster Thesis
dc.type.qualificationlevelMasters
dc.type.qualificationnameMMeden_ZA
uct.type.filetypeText
uct.type.filetypeImage
uct.type.publicationResearchen_ZA
uct.type.resourceThesisen_ZA
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