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

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.

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.

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.

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.