Table 3 Surgical management of study patients, 11 May 2018 to 31 October 2020, Gaza, Palestine
Characteristics | All Patients (N = 244) | Orthopedic (N = 64) | Orthopedic and Plastic (N = 135) | Ortho-Plastic (N = 45) | p-value |
|---|---|---|---|---|---|
Surgical – throughout the case management | |||||
Rotational flap – n (%) |  |  |  |  |  |
 Yes | 47 (19.3%) | 2 (3.2%) | 32 (23.7%) | 13 (28.9%) | < 0.001†|
 No | 196 (80.7%) | 61 (96.8%) | 103 (76.3%) | 32 (71.1%) |  |
Free Flap – n (%) |  |  |  |  |  |
 Yes | 1 (0.4%) | 0 (0.0%) | 1 (0.7%) | 0 (0.0%) | 1.00‡ |
 No | 242 (99.6%) | 63 (100.0%) | 134 (99.3%) | 45 (100.0%) |  |
Fasciocutaneous Flap – n (%) |  |  |  |  |  |
 Yes | 26 (10.7%) | 1 (1.6%) | 20 (14.8%) | 5 (11.1%) | 0.02†|
 No | 217 (89.3%) | 62 (98.4%) | 115 (85.2%) | 40 (88.9%) |  |
Split-thickness skin graft (STSG) – n (%) | |||||
 Yes | 176 (72.4%) | 12 (19.0%) | 122 (90.4%) | 42 (93.3%) | < 0.001†|
 No | 67 (27.6%) | 51 (81.0%) | 13 (9.6%) | 3 (6.7%) |  |
Debridement – [n (Mean ± SD)] | |||||
|  | 2.6 ± 1.7 | 2.2 ± 1.4 | 3.0 ± 1.9 | 2.0 ± 1.3 | < 0.001* |
Different fixators – n (%) |  |  |  |  |  |
 1 | 128 (52.7%) | 29 (46.0%) | 76 (56.3%) | 23 (51.1%) | 0.30‡ |
 2 | 100 (41.2%) | 27 (42.9%) | 52 (38.5%) | 21 (46.7%) |  |
 3 | 15 (6.2%) | 7 (11.1%) | 7 (5.2%) | 1 (2.2%) |  |
Definitive fixator type – n (%) |  |  |  |  | |
 Monorail fixator | 128 (52.7%) | 28 (44.4%) | 80 (59.3%) | 20 (44.4%) | 0.08‡ |
 Ilizarov | 51 (21.0%) | 15 (23.8%) | 22 (16.3%) | 14 (31.1%) |  |
 Tsf | 58 (23.9%) | 16 (25.4%) | 31 (23.0%) | 11 (24.4%) |  |
 Lrs | 6 (2.5%) | 4 (6.3%) | 2 (1.5%) | 0 (0.0%) |  |
Internal fixation – n (%) |  |  |  |  |  |
 Yes | 15 (6.2%) | 4 (6.3%) | 8 (5.9%) | 3 (6.7%) | 1.00‡ |
 No | 228 (93.8%) | 59 (93.7%) | 127 (94.1%) | 42 (93.3%) |  |
Definitive fixator at first application – n (%) | |||||
 Yes | 118 (48.6%) | 26 (41.3%) | 71 (52.6%) | 21 (46.7%) | 0.32†|
 No | 125 (51.4%) | 37 (58.7%) | 64 (47.4%) | 24 (53.3%) |  |
Ankle Spanning# – n (%) |  |  |  |  |  |
 Yes | 17 (10.3%) | 6 (14.3%) | 7 (7.8%) | 4 (12.1%) | 0.45‡ |
 No | 148 (89.7%) | 36 (85.7%) | 83 (92.2%) | 29 (87.9%) |  |
Knee Spanning# – n (%) |  |  |  |  |  |
 Yes | 18 (10.9%) | 5 (11.9%) | 8 (8.9%) | 5 (15.2%) | 0.50‡ |
 No | 147 (89.1%) | 37 (88.1%) | 82 (91.1%) | 28 (84.8%) |  |
Bone Graft# – n (%) |  |  |  |  |  |
 Yes | 102 (45.3%) | 26 (47.3%) | 52 (40.6%) | 24 (57.1%) | 0.17†|
 No | 123 (54.7%) | 29 (52.7%) | 76 (59.4%) | 18 (42.9%) |  |
Duration till 1st bone graft – [days, median (IQR)] # | |||||
| Â | 235.0 (136.0-380.8) | 250.0 (149.3-319.8) | 235.0 (122.0-399.5) | 219.5 (160.0-473.3) | 0.42* |
Total number of surgeries – (mean ± SD) | |||||
|  | 9.6 ± 4.2 | 8.3 ± 4.1 | 10.3 ± 4.0 | 9.6 ± 4.4 | 0.008* |
Time injury to fixation – [days, n (%)] | |||||
 0 | 232 (95.5%) | 61 (96.8%) | 127 (94.1%) | 44 (97.8%) | 0.53‡ |
 ≥ 1 | 11 (4.5%) | 2 (3.2%) | 8 (5.9%) | 1 (2.2%) |  |
Time to definitive stabilization – [days, n (%)) | |||||
 Median (IQR) | 97.0 (0.0-257.0) | 114.0 (0.0-276.0) | 57.0 (0.0-259.8) | 133.5 (0.0-209.8) | 0.06†|