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Open Fracture Care During War

Opportunities for Research

Rivera, Jessica C., MD1,2,a; Wenke, Joseph C., PhD1; Pugh, Mary Jo, RN, PhD3

doi: 10.2106/JBJS.RVW.15.00105
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Disclosures

  • ➢ Reported infection rates following severe open fractures of the lower extremity sustained in combat have varied widely, from 23% to 85%. The infection rates have been either similar to or higher than those reported in the civilian trauma literature.
  • ➢ Deployed surgeons have increased the frequency of fasciotomy procedures for limbs with or at risk for clinical compartment syndrome. The long-term sequelae of compartment syndrome and fasciotomies are not clearly defined.
  • ➢ The definition of the term late amputation has varied in the literature, and studies have not consistently included information on the causes of the amputations.
  • ➢ Preclinical and clinical translational studies on the reduction of the rates of infection and other limb morbidities are needed to address the acute care of combat extremity wounds.

1United States Army Institute of Surgical Research, JBSA Fort Sam Houston, San Antonio, Texas

2Department of Orthopaedic Surgery, San Antonio Military Medical Center, San Antonio, Texas

3VERDICT Research Group, South Texas Veterans Healthcare System, San Antonio, Texas

aE-mail address for J.C. Rivera: Jessica.c.rivera14.mil@mail.mil

Copyright © 2016 by The Journal of Bone and Joint Surgery, Incorporated
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