Reemployment of patients with surgical salvage of open, high-energy tibial fractures: an outcome study.

Between January 1, 1988, and December 31, 1990, 36 patients with 37 type III high-energy open tibial shaft fractures were treated at Lehigh Valley Hospital. Patients with primary amputations were excluded. All patients with high-energy open tibial fractures with an intact posterior tibial nerve, protective sensations of the plantar surface of the foot, and warm ischemia time of less than 6 hours were considered salvageable. A retrospective review of the charts was completed. Twenty-eight patients with 29 fractures were interviewed for work status, an average of 39 months after treatment. Twenty-five patients with 25 fractures were working at the time of the accident. Three patients with four fractures were not working at the time of the accident. Nineteen of 25 patients (76%) returned to work. Sixteen of 25 patients (64%) returned to work at a similar level of manual labor. The average delay between injury and return to work was 11 months (range, 3-18 months). Two of the 36 patients (5.5%) required secondary amputations. Twenty-five of 28 patients (89%) interviewed reported one or more subjective complaints. The two amputees reported no subjective complaints.