EVALUATION OF MANAGEMENT OF GUSTILO TYPE IIIB OPEN WOUND ACCORDING TO GANGA HOSPITAL OPEN INJURY SEVERITY SCORE (GHOISS)

Abstract

Introduction: In this era of high speedy vehicles road trafc accidents leading to polytrauma and open fractures are very common.There is a lot of confusion regarding amputation or salvage on day 1, particularly in managing open fractures gustilo type IIIB. So there is an urgent need of a scoring system which can prognosticate limb salvage or amputation. Aim: To evaluate the results of open fracture (specially type IIIB) management according to GANGA score and to estimate how successfully it can prognosticate limb salvage or amputation. Materials And Methods: In this prospective study for 1.5 years duration ,50 patients were selected randomly with Gustilo type IIIB open wound from emergency and OPD of ORTHOPAEDICS department (N.R.S.M.C.H) and they were evaluated using GANGA score and MESS score. A multidisciplinary approach was taken to manage the open fracture with proper and timely consultation of vascular and plastic surgeon. Results: Sensitivity and specicity of Ganga score is 100% and 97.82% and that of MESS score is 50% and 86.95%. The positive predictive value of Ganga score is 80% and that of MESS score is 25%. So Ganga score is having greater practical value. Conclusion: This score acts as a predictable single scoring system for both limb salvage and amputation and it can successfully address the dilemma of Primary amputation or limb salvage on Day 1 in type IIIB injury.