TITLE:
Time Management of Open Lower-Leg Fractures in Morocco
AUTHORS:
Adonis Magoumou, Yassir El Andaloussi, Simohamed Fahsi, Othmane Hiba, Mustapha Fadili, Mohamed Nechad, Mohamed Ouarab, Fatima Zahra Widad, Samira Nani, Samira Hassoune, Abderrahmane Maaroufi
KEYWORDS:
Open Fracture, Lower-Leg Fracture, Chu Ibn Rochd, Casablanca
JOURNAL NAME:
Open Journal of Emergency Medicine,
Vol.2 No.3,
September
3,
2014
ABSTRACT: Background: It is recommended that the management of open lower-leg fractures should occur within six hours to avoid complications affecting both prognosis and functionality. This study aimed to evaluate the time taken for each step of management, identify causes of delay, and propose solutions to reduce the rate of complications. Patients and methods: This was a prospective study involving 153 patients treated from January 2011 to December 2012. Standardized data collection forms documented the times taken for each management step from the accident until surgical intervention. Results: For patients admitted directly to our institution, median time to surgical debridement from arrival was 5 hours. Median time for bone fixation was 24 hours. External fixation was used in 119 patients. There were several causes of delay; lack of financial resources was the most common. Certain causes of delay were significantly correlated with time to debridement. However, although 86.7% of patients who developed an infection had a time from injury to debridement greater than six hours, there was no statistically significant association between infection and delay beyond six hours (p = 0.403). Conclusion: By identifying causes of treatment delay, we hope to be able to avoid complications, and therefore reduce the socio- economic impact of these important surgical emergencies.