Clinical outcomes of supracondylar femur ao type B and C 3A open fractures

Introduction and Objective: Femoral supracondylar AO Type B and C Type 3A open fractures are severe injuries caused by high-energy trauma. These fractures are particularly associated with gunshot wounds and traffic accidents. Our study aimed to retrospectively evaluate the effectiveness of surgical methods used in the treatment of such fractures, the relationship between biomarkers and clinical outcomes, and the factors influencing treatment processes. Additionally, differences in healing processes between open fractures caused by gunshot wounds and those resulting from other trauma types were investigated. Materials and Methods: A total of 44 patients diagnosed with AO Type B and C Type 3A open fractures at Dicle University between 2011 and 2024 were retrospectively evaluated. The patients were divided into two groups based on whether they sustained a gunshot wound. Laboratory parameters such as LDH, albumin, neutrophil/lymphocyte ratio (NLR), and monocyte/lymphocyte ratio (MLR) from initial blood samples were recorded. Clinical outcomes were compared concerning fracture union, range of joint motion, and scoring systems. Results: A significant difference was found in union rates between the ASY and non-ASY groups, with union rates of 13/6 in the ASY group and 22/3 in the non-ASY group (p<0.001). The NEER and HSS scores were found to be significantly higher in the non-ASY open injury group compared to the ASY group (p<0.001). The ROM (Range of Motion) values were significantly higher in the non-ASY open injury group compared to the ASY group (p=0.002). A significant difference in fracture type was found between the union group and the nonunion group (p=0.003). The time to surgery was significantly different between the groups, with an average of 4.3 days in the union group and 5.4 days in the nonunion group (p=0.003). Albumin levels were significantly higher in the union group compared to the nonunion group (p<0.001). The neutrophil/lymphocyte ratio (NLR) was significantly higher in the nonunion group compared to the union group (p<0.001). The monocyte/lymphocyte ratio (MLR) was significantly higher in the nonunion group compared to the union group (p<0.001). The LDH/Albumin ratio was significantly higher in the nonunion group compared to the union group (p=0.04). Among patients without gunshot injuries, the NLR and MLR values were higher in the nonunion cases compared to the union cases. Similarly, for patients with gunshot injuries, NLR and MLR values were also higher in the nonunion group than in the union group (p<0.001). Conclusion: We believe that laboratory parameters can be utilized to predict clinical prognosis in femoral supracondylar AO Type B and C Type 3A open fractures. In the same type of open fractures, we consider that gunshot-induced fractures result in worse outcomes. The findings of this study may guide treatment approaches and provide significant contributions to the literature. Keywords: Femur, Distal, HSS, Neer, ASY