Complicaciones en fracturas expuestas de extremidades inferiores. revisión sistemática

Abstract

Open fractures represent a global health issue due to their unfavorable prognosis. In the United States, 11.5 individuals per 100,000 experience these fractures each year, with 40% occurring in the lower limbs. Objective: To analyze data on the most common complications of open fractures in the lower limbs. Methodology: A systematic review was developed on complications associated with open fractures in the lower extremities. The scientific articles were searched in databases such as SciELO, PubMed, and Google Scholar, including publications from 2018 to 2022. The selected studies were evaluated using the PRISMA 2020 method and the GRADE scale to classify the quality of information. The PICO strategy was applied to structure the research. Data were organized and presented in tables. Results: An initial pool of 5,134 records was identified, of which eight studies were included in the qualitative synthesis. These studies revealed a high prevalence of infectious complications, with infection rates ranging from 19% to 40.4%. Other identified complications included pseudarthrosis, suture dehiscence, amputations, osteomyelitis, shortening, compartment syndrome, and fatigue of osteosynthesis materials. According to Gustilo-Anderson, grade III fractures exhibited the highest complication rates. Conclusions: Open fractures in the lower limbs are expected, with tibial fractures being the most prevalent and showing a high incidence of Grade III fractures. Infections are the most frequent complication, followed by nonunion and compartment syndrome. Keywords: open fracture, complications, lower limbs, infections