Nayyer Qayyum.
Management plan of open fractures with Gustilo III-C gunshot injury.
J Pak Orthop Assoc Jan ;24(2):91-7.

Objective : To give a definitive management plan of open fractures with vascular injuryin Gunshot Wounds. Study Design: A Prospective Descriptive Study. Place and Duration of Study: RMC and Allied Hospitals mainly DHQ Hospital Rawalpindi, Department of Orthopaedics from June 2009 to June 2011. Patients and Methods: 44 Patients having open fracture with Vascular Injury secondary to Gunshot Injury were included in the study reporting in 1st 12 hours of Injury. The average follow up was 20 months. Only Gustilo IIIC fractures were included and were further sub classified by Nayyer-Nadeem sub classification of Gustilo IIIc Injury secondary to gunshot wounds. The patients were treated according to the sub classification system. The functional outcome was measured in terms of Limb Saving, Union, Infection and Rehabilitation Results: Out of 44 patients 34 were male and 10 patients were female. Mean age was 32 Years, 78% had trauma to lower limb and 22% had trauma to upper limb, mean duration of hospital stay was 18 days and average follow up was up to 20 months. The mean duration of Injury till treatment was 4.5 hours. 5% had Limb amputation, 88% had satisfactory union in 16 months, 18% had superficial infection, 6% had deep infection and 80% were rehabilitated in first 1.5 months to achieve the better functional outcome. Conclusion: Following Nayyer-Nadeem sub classification and treatment plan give better results in Gustilo type IIIc injuries in gunshot wounds.

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