Journal of Musculoskeletal Trauma

Salvage Therapy from Traumatic Ischemic Finger Necrosis via Prostaglandin E1 Assisted Conservative Treatment: A Case Report: Jae Hyuk Shin, Ho Guen Chang, Cheol Jung Yang, Jungtae Ahn; J Korean Fract Soc 2015;28(4):245-249. Published online October 31, 2015; DOI: https://doi.org/10.12671/jkfs.2015.28.4.245

Abstract PDF: Prostaglandin E1 (PGE-1) is a potent vasodilator, which also inhibits platelet aggregation, affects the blood flow viscosity, and fibrinolysis. The compound also excerts anti-inflammatory effects by inhibiting the monocyte and neutrophil function. PGE-1 has been widely administered following microvascular flap surgery, along with perioperative antithrombotic agents such as low molecular weight heparin or aspirin, showing excellent results. We report a case showing successful salvage recovery from post-traumatic ischemic necrosis of the finger via PGE-1 assisted conservative treatment.

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Limb Salvage versus Early Amputation according to Mangled Extremity Severity Score in Treatment of the Lower Extremity Open Fractures associated with Severe Soft Tissue Injury: Kyung Jin Song, Yong Min Kim, Kyung Rae Lee; J Korean Soc Fract 2002;15(1):28-35. Published online January 31, 2002; DOI: https://doi.org/10.12671/jksf.2002.15.1.28

Abstract PDF: PURPOSE
To evaluate the availability of the mangled extremity severity score(MESS) in deciding the early treatment modality for the patients with open lower extremity fractures and severe soft tissue injury.
MATERIALS AND METHODS
Analyzed 27 patients for the lower extremity open fractures with extensive soft tissue injury. A comparative study using a MESS, a cause of injury, vascular injury and a fracture pattern, average hospital stay and average hospital charges were analyzed, and daily living ability and subjective self-evaluation were assessed.
RESULTS
There was statistically significant correlation applying MESS to patient group that had been operated by early amputation because of severe soft tissue and vascular injury. But there was no significant difference in the subjective self-assessment score, admission period and total cost during admission between each treatment method.
CONCLUSION
MESS can be used as an objective assessment criteria in deciding the proper treatment modality for the cases of lower limbs fracture with extensive soft tissues and vascular injury.

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Arterial Injuries associated with Fractures or Dislocations around the Knee: Chang Wug Oh, Joo Chul Ihn, Byung Chul Park, Il Hyung Park, Shin Yoon Kim, Hee Soo Kim; J Korean Soc Fract 1999;12(4):865-871. Published online October 31, 1999; DOI: https://doi.org/10.12671/jksf.1999.12.4.865

Abstract PDF: The purpose of this article is to delineate factors important in successful management and subsequent extremity function of the patient with arterial injury associated with fractures or dislocations around the knee. We reviewed 25 cases of arterial injury associated with fractures or dislocations around the knee which were treated at our hospital between 1994 and 1998. As long term results, the salvage rate of the lower limb was related to the extent of the soft tissue damage and the severity of infection, but there was no statistical difference according to the method of vascular surgery(p=0.645). Compared with the salvage rate of the lower limb according to the length of time from injury to vascular reanastomosis, there was no statistical difference between two groups of the patients who were operated within 12 hours and were operated during the time between 12 hours and 24 hours(p=0.084). In view of whether open or closed fractures were combined, 1 I cases(58%) among 19 cases of open fractures and 5 cases(83%) among S cases of close(1 fractures were able to salvage the lower limb, so it could contributes to the sdlvdge rate of the limb. Finally 16 cases(64%) among total 25 cases were able to salvage the lower limb, and its functional outcome was like followings : excellent results were found in 6 cases, fair results in 8 cases, poor results in 2 cases, and amputation in 9 cases(36%). In case of amputation, 3 cases were primarily amputated and 6 cases were amputated secondary to vascular surgery . As long term results, whether open or closed fractures were combined, the teverity of the infection and the extent of the soft tissue necrosis were the factors influencing on the falvage rate of the lower limb. Other factors, such as the difference of ischemic time within 24 hours interval, the site and the method of management of the fractures and the vascular injuries and whether fasciotomy was performed or not were not important factors influencing on the salvage rate of the lower limb.

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Treatment of the Long Bone fractures Assuiated with Vascular Injuries: Myun Whan Ahn, Yong Seok Choi, Jong Chal Ahn; J Korean Soc Fract 1994;7(1):113-121. Published online May 31, 1994; DOI: https://doi.org/10.12671/jksf.1994.7.1.113

Abstract PDF: Vascular injuries combined with long bone fractures have been infrequent and difficult to manage. Despite of recent advancement in the vacular repalr and fixation of fracutres, it is not easy to save the limb. In order to identify the factor associated with amputation or salvage of the affected limb, a retrospective study of 14 patients whose injured vessels were repaired primarily at the time of bone fixation was perfomed. The ischemic time, the degree of soft tissue or bone injury and the method of treatment were evaluated with relation to the limb salvage, 4(28.6%) of that 14 long bone fractures needed secondary amputation due to a vascular insufficiency. In 3 of 4 fractures, in which vascular repair were delayed over 24 hours, afftected limbs were amputated later. Thus, the ischemnic time was determined as an important factor for limb salvage after the vascular injury associated with the long bone fracture(p<0.05). However, the dogree of the soft tissue of bone injury and the method of treatment were not correlated with the limb salvage.

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