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CC BY-NC-ND 4.0 · Revista Chilena de Ortopedia y Traumatología 2024; 65(02): e74-e77
DOI: 10.1055/s-0044-1788600
Artículo Original | Original Article

High Rate of Postoperative Complications in Ballistic Distal Femur Fractures

Article in several languages: español | English
Sergio Arellano
1   Equipo de Rodilla, Departamento de Traumatología, Hospital Padre Hurtado, Santiago, Chile
2   Clínica Alemana, Facultad de Medicina, Universidad del Desarrollo, Santiago, Chile
,
Nicolás González-Kusjanovic
1   Equipo de Rodilla, Departamento de Traumatología, Hospital Padre Hurtado, Santiago, Chile
3   Departamento de Traumatología y Ortopedia, Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
,
Zoy Anastasiadis 
1   Equipo de Rodilla, Departamento de Traumatología, Hospital Padre Hurtado, Santiago, Chile
,
Rodrigo Guiloff 
2   Clínica Alemana, Facultad de Medicina, Universidad del Desarrollo, Santiago, Chile
,
Diego Edwards
2   Clínica Alemana, Facultad de Medicina, Universidad del Desarrollo, Santiago, Chile
,
Andrés Schmidt-Hebbel
1   Equipo de Rodilla, Departamento de Traumatología, Hospital Padre Hurtado, Santiago, Chile
2   Clínica Alemana, Facultad de Medicina, Universidad del Desarrollo, Santiago, Chile
,
Alex Vaisman 
2   Clínica Alemana, Facultad de Medicina, Universidad del Desarrollo, Santiago, Chile
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Abstract

Introduction Femur fractures are among the most common injuries caused by gunshots. However, distal femur fractures due to gunshots are scarcely studied in the literature.

Objective To present a cohort of patients with distal femur fractures caused by gunshots treated surgically and to analyze their complications.

Materials and Methods A retrospective cohort study of patients operated on for distal femur fractures caused by gunshots in a public hospital in an area with a vulnerable population, from 2011 to 2015. Demographic variables, days from admission to definitive surgery, intraoperative time, type of definitive osteosynthesis, complications, and one-year mortality were recorded.

Results In total, 39 patients met the inclusion criteria; they had a mean age of 30 (range: 16–53) years, and 85% were men. The mean latency until the definitive osteosynthesis was of 9.8 (range: 1–33) days. The overall complication rate was of 25.64%, with a reintervention rate of 23.08%. The main complication was infection (12.82%). There were no statistically significant factors associated with complications. There were no deaths at the one-year follow-up.

Conclusion Patients with distal femur fractures caused by gunshots present a high rate of complications, especially infections, with a high rate of reinterventions.

Level of Evidence: Type IV, retrospective study.

Keywords

distal femur - gunshot fracture - complications


Publication History

Received: 19 April 2020

Accepted: 29 May 2024

Article published online:
26 July 2024

© 2024. Sociedad Chilena de Ortopedia y Traumatologia. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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  • Referencias

  • 1 Persad IJ, Reddy RS, Saunders MA, Patel J. Gunshot injuries to the extremities: experience of a U.K. trauma centre. Injury 2005; 36 (03) 407-411
    CrossrefPubMedSearch in Google Scholar
  • 2 Lyons JG. Epidemiology of ballistic fractures in the United States: A 20-year analysis of the Firearm Injury Surveillance Study. Injury 2022; 53 (11) 3663-3672
    CrossrefPubMedSearch in Google Scholar
  • 3 Mehta SK, Dale WW, Dedwylder MD, Bergin PF, Spitler CA. Rates of neurovascular injury, compartment syndrome, and early infection in operatively treated civilian ballistic forearm fractures. Injury 2018; 49 (12) 2244-2247
    CrossrefPubMedSearch in Google Scholar
  • 4 Jakoet MS, Burger M, Van Heukelum M. et al. The epidemiology and orthopaedic burden of civilian gunshot injuries over a four-year period at a level one trauma unit in Cape Town, South Africa. Int Orthop 2020; 44 (10) 1897-1904
    CrossrefPubMedSearch in Google Scholar
  • 5 Court-Brown CM, Caesar B. Epidemiology of adult fractures: A review. Injury 2006; 37 (08) 691-697
    CrossrefPubMedSearch in Google Scholar
  • 6 Chan DB, Jeffcoat DM, Lorich DG, Helfet DL. Nonunions around the knee joint. Int Orthop 2010; 34 (02) 271-281
    CrossrefPubMedSearch in Google Scholar
  • 7 Henderson CE, Lujan TJ, Kuhl LL, Bottlang M, Fitzpatrick DC, Marsh JL. 2010 mid-America Orthopaedic Association Physician in Training Award: healing complications are common after locked plating for distal femur fractures. Clin Orthop Relat Res 2011; 469 (06) 1757-1765
    CrossrefPubMedSearch in Google Scholar
  • 8 von Elm E, Altman DG, Egger M, Pocock SJ, Gøtzsche PC, Vandenbroucke JP. STROBE Initiative. The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement: guidelines for reporting observational studies. Lancet 2007; 370 (9596): 1453-1457
    CrossrefPubMedSearch in Google Scholar
  • 9 Baum GR, Baum JT, Hayward D, MacKay BJ. Gunshot Wounds: Ballistics, Pathology, and Treatment Recommendations, with a Focus on Retained Bullets. Orthop Res Rev 2022; 14: 293-317
    PubMedSearch in Google Scholar
  • 10 Penn-Barwell JG, Bennett PM, Mortiboy DE, Fries CA, Groom AFG, Sargeant ID. Factors influencing infection in 10 years of battlefield open tibia fractures. Strateg Trauma Limb Reconstr 2016; 11 (01) 13-18
    CrossrefPubMedSearch in Google Scholar
  • 11 Ordog GJ, Sheppard GF, Wasserberger JS, Balasubramanium S, Shoemaker WC. Infection in minor gunshot wounds. J Trauma 1993; 34 (03) 358-365
    CrossrefPubMedSearch in Google Scholar
  • 12 Polat G, Balci HI, Ergin ON, Asma A, Şen C, Kiliçoğlu Ö. A comparison of external fixation and locked intramedullary nailing in the treatment of femoral diaphysis fractures from gunshot injuries. Eur J Trauma Emerg Surg 2018; 44 (03) 451-455
    CrossrefPubMedSearch in Google Scholar
  • 13 Peschiera V, Staletti L, Cavanna M, Saporito M, Berlusconi M. Predicting the failure in distal femur fractures. Injury 2018; 49 (Suppl. 03) S2-S7
    CrossrefPubMedSearch in Google Scholar
  • 14 Streubel PN, Ricci WM, Wong A, Gardner MJ. Mortality after distal femur fractures in elderly patients. Clin Orthop Relat Res 2011; 469 (04) 1188-1196
    CrossrefPubMedSearch in Google Scholar