A Study of Pattern, Management, and Outcome of Complex Soft-Tissue Injuries.

Background and Objectives: Complex soft-tissue injuries are one of the leading causes of morbidity and mortality following road traffic accidents (RTA). This article is regarding the pattern, management, and outcome of complex soft-tissue injuries. Methods: This observational study was conducted on 519 patients, from January 01, 2010, to April 30, 2013, at a tertiary care center in southern India. We analyzed the demographic profile, mechanism of injuries, management, and outcome of complex soft-tissue injuries during this study. Results: Of 519 patients with soft-tissue injury, blunt and penetrating injuries were seen in 81.7% and 18.3% of all cases, respectively. The most common cause of injury was RTA 74.3%. Isolated moral Lavelle injuries without associated neurovascular injuries occurred in 26.3% of patients. Soft-tissue injury was associated with bony, vascular, nerve, and tendon injuries in 52.0%, 44.7%, 20.0%, and 16.3% of all the cases, respectively. Patients who presented early (within 6 h of injuries) and patients with bone-only injuries had higher limb salvage rates. The overall morbidity rate among adults was 16.3% and the mortality rate was 1.9% and the most common cause of death was hemorrhagic shock. Mortality and morbidity in the pediatric group are higher than in the adult group. Conclusions: In summary, health education about road safety and proper safety protocol for two-wheelers and four-wheelers will reduce the incidence of RTA, thereby reducing the incidence of complex soft-tissue injury. The early and aggressive intervention will prevent a high amputation rate in bony injuries combined with vascular injury. A low threshold of blood transfusion and early aggressive treatment in the pediatric population will reduce the high mortality rate. [ABSTRACT FROM AUTHOR]