XXXX : an assessment of procedures in 27 cases.

@entity1 @entity281 @entity2054 @entity174
Twenty-seven @entity1 (two @entity1 ) with @entity174 (19 open) were treated in our institution with a mean age of 38.9 years (range 22-67 years) and a mean Injury Severity Score of 11.5 (9-34). Sixteen @entity174 were stabilised initially with an interlocking nail, seven with an external fixator, one with a hybrid external fixator, two cases were plated and one was treated in plaster. The mean size of the segment was 11.5 cm (range 4-20 cm). Soft tissue coverage was required in 17 cases. There were three cases of @entity2054 , six cases of superficial @entity281 cases (two of which required amputation). In four cases, excision of the non-viable segment was necessary. Overall, 13 @entity1 were subjected to a second operative procedure (OP) (four external fixators were replaced with the AO solid tibial nail, two Ilizarov bone transports following excision of the dead bone segment, 2 below knee amputations, 3 exchange reamed nailings, 1 LISS plate application for stability and 1 ring fixator for compression of a @entity174 ). Five @entity1 underwent third procedure (two Ilizarov for bone transport, two exchange nailing, and one bone grafting). The mean time to union of the proximal segment was 38.8 weeks (range 10-78 weeks) and 41.4 weeks (range 12-65 weeks) for the distal segment, respectively. The treatment of @entity174 poses many problems to the surgeon due to the precarious blood supply of the intermediate segment. The risk of non-union delayed union, @entity281 and additional procedures is high as seen in this series of @entity1 .
