LOWER LIMB FRACTURELOWER LIMB FRACTUREComplicationsComplications
Professor Jegan KrishnanProfessor Jegan KrishnanFlinders UniversityFlinders University
Adelaide, South AustraliaAdelaide, South Australia
Specialists Without BordersSeminar in Surgery
Rwanda, September 2010
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Learning ObjectivesLearning Objectives Identifying the common lower limb fracture complications Early assessment and management Prevention of complications
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InfectionInfection
Infection at fracture prevented by early and maticulouss debridement Early appropriate antibiotics Fracture stabilisation Soft tissue coverage
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Compartment SyndromeCompartment Syndrome Most common fracture complication missed Early assessment Clinical features Compartment Pressure Measurements Early Fasciotomy
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Vascular InjuryVascular Injury Early recognition Early Investigation Vascular Surgery Consultation Reanastomosis
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Vascular InjuryVascular Injury
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Neurological InjuryNeurological Injury
Early assessment both pre-reduction and post reduction
Majority of injuries are neuropraxia When to explore is a tricky decision
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Neuropraxia Neuropraxia Early recognition Determine level of injury Observe recovery rate Nerve conduction test and EMG Explore if recovery rate not progressing as expected
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Non UnionNon Union
Definition Types – Hypertrophic
– Atrophic Management – Stabilisation
– Bone Grafting
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MalunionMalunion Definition Management
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SUMMARYSUMMARY
Best management is prevention Early suspicion Early recognition Early correction Late corrective options are available
