Analysis of Timing of Definitive Fixation of Fractures Based on Lactate and Base Excess Monitoring in Polytrauma patients

Venkatesh, M (2020) Analysis of Timing of Definitive Fixation of Fractures Based on Lactate and Base Excess Monitoring in Polytrauma patients. Masters thesis, Kilpauk Medical College, Chennai.


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BACKGROUND: This study applies criteria to a cohort of patients with Orthopaedic injuries and determines clinical outcomes for groups stratified by timing of fracture fixation based on lactate and base excess and to analyse the trend of lactate and base excess in polytrauma patients. This study also determines the complication developed after definitive treatment in stable and borderline patient. AIM OF THE STUDY: The aim is to analyse the timing of definitive fixation of multiple long bone fractures based on lactate and base excess monitoring in polytraumatised patient assessing risk for complications. METHODS: This study was conducted in 25 patients who got admitted in Royapettah Govt. Hospital and Kilpauk Medical College hospital after getting ethical committee clearance and after getting patient consent. Fractures were treated surgically after lactate and base excess values are normalised on serial monitoring at admission, 24 hours, 48 hours, day 3 , day 5 etc. and patients were described as stable, borderline, unstable using a modified CGS and post-operative outcome noted. RESULTS: Out Of 25 Patients, 17 had Shaft of Femur Fracture, 2 had Bilateral Both Bone Fracture of Leg, 3 Had Floating Knee, 2 patient had floating elbow, 14 Patients Had Fracture Both Bone Leg, 1 Patient Has Bilateral Femur Fracture, 10 Patient Had Upper Limb Fracture. 2 had fat embolism complication and femoral shaft fractures shows association with fat embolism. Out of 25 patients, 20 patients are classified as stable and 5 are borderline patients. 20 Out of 25 patient are considered stable, the day of surgery ranges (average of 5.8) from 3 to 7 days considered safe based on lactate and in case of borderline patients, and it varies between 4 to 7 days in 3 patients without any complication. CONCLUSION: We conclude serum lactate and base excess is useful in deciding the timing of definitive fixation with normal vital parameters resulted in good outcome and the safe period for definitive fixation ranges between 3 to 7 days without any complication.

Item Type: Thesis (Masters)
Additional Information: 221712158
Uncontrolled Keywords: Serum lactate, base excess, polytrauma, Injury Severity Score, Clinical Grading system, timing of definitive fixation.
Subjects: MEDICAL > Orthopaedics
Depositing User: Subramani R
Date Deposited: 13 Feb 2021 15:49
Last Modified: 13 Feb 2021 15:49

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