Closed Limb Fractures With Compromised Vascularization: A Narrative Review.

Closed Limb Fractures With Compromised Vascularization: A Narrative Review. Clin Med Insights Arthritis Musculoskelet Disord. 2019;12:1179544119836742 Authors: Vannabouathong C, Schemitsch E, Petrisor B, Bhandari M Abstract Vascular compromised fractures typically result in a high rate of healing complications, such as avascular necrosis, nonunion, delayed union, and arthritis, which severely affect a patient's function and quality of life. The purpose of this review was to identify and describe the epidemiology and available treatment options for the most well-known vascular compromised closed fractures. The injuries discussed in detail in this review were scaphoid, lunate, femoral neck, and talar fractures. Current evidence suggests that optimal treatment for vascular compromised fractures is dependent on the degree of fracture displacement and comminution, and the patient's post-injury functional demands, age, and bone quality. Conservative efforts generally include casting or splinting with a period of immobilization. Surgery is indicated for substantially displaced fractures, patients who require higher functional demands and an earlier return to activity, or if complications occur following nonoperative treatment; however, operative intervention is typically performed for femoral neck fractures regardless of the amount of displacement. Various surgical techniques exist, though internal fixation with screws is a common procedure...
Source: Clinical Medicine Insights: Arthritis and Musculoskeletal Disorders - Category: Orthopaedics Tags: Clin Med Insights Arthritis Musculoskelet Disord Source Type: research