Should lower limb fractures be treated surgically in patients with chronic spinal injuries? Experience in a reference centre

Abstract

Objective: To report the outcomes of surgical treatment of lower limb fractures in patients with chronic spinal cord injuries.

Material and method: A total of 37 lower limb fractures were treated from 2003 to 2010, of which 25 fractures were treated surgically and 12 orthopaedically.

Results: Patients of the surgical group had better clinical results, range of motion, bone consolidation, and less pressure ulcers and radiological misalignment. No differences were detected between groups in terms of pain, hospital stay, and medical complications.

Discussion: There is no currently consensus regarding the management of lower limb fractures in patients with chronic spinal cord injuries, but the trend has been conservative treatment due to the high rate of complications in surgical treatment.

Conclusions: Chronic spinal cord injuries patients with lower limb fractures who are treated surgically achieved a more reliable consolidation, practically a free range of motion, low rate of cutaneous complications, and pain associated with the fracture. This allows a quick return to the previous standard of living, and should be considered as an alternative to orthopaedic treatment in these patients.

Keywords: Chronic spinal cord injury; Conservative treatment; Fijación quirúrgica; Fractura extremidad inferior; Lesión medular crónica; Lower limb fractures; Surgical fixation; Surgical treatment; Tratamiento conservador; Tratamiento quirúrgico.