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Retrograde nailing of the femur, intramedullary nailing of the tibia, ankle debridement and casting
3%
40/1267
External fixation of the femur, intramedullary nailing of the tibia, ankle debridement and ORIF
1%
12/1267
Antegrade nailing of the femur, external fixation of the tibia and ankle after debridement
9%
112/1267
Retrograde nailing of the femur, intramedullary nailing of the tibia, ankle debridement and ORIF
82%
1041/1267
External fixation of the tibia and femur, and ankle debridement and external fixation
4%
55/1267
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The patient is hemodynamically stable, has no other injuries, and is medically cleared for the operating room. Therefore, there is no need for damage control fixation. Ostrum et al conducted a review of 20 patients treated by percutaneous stabilization for ipsilateral fractures of the femur and tibial shafts. All patients were treated with a retrograde femoral intramedullary nail and a small diameter tibial intramedullary nail through a 4-cm medial parapatellar tendon incision. Six of the tibial shaft fractures required revision surgery, and no patients reported signs or symptoms of knee pain. Ostrum concluded that although this is an excellent treatment option for patients with ipsilateral femoral and tibial shaft fractures, the tibial fracture complication rates remain high. Franklin et al reviewed 38 cases of open ankle fractures that had been treated with immediate splinting, antibiotics, debridement, and internal fixation. They found that all of the fractures united, but three patients required subsequent ankle fusion because of cartilage damage noted at the initial operation. Of the thirty-five ankles with complete follow-up, the functional result was excellent in twenty-six and fair or poor in nine.
3.5
(31)
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