Aeromonas hydrophila-related fulminant necrotizing fasciitis and arterial embolization after plaster placement in Gustilo I distal radius fracture: a case report and literature review
Abstract Background Distal radius fractures are prevalent among the elderly. In cases of Gustilo I open distal radius fractures, standard initial management involves irrigation, debridement, reduction, and external fixation. Subsequently, external fixation may serve as the definitive treatment or tr...
Saved in:
| Main Authors: | , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
BMC
2025-08-01
|
| Series: | BMC Musculoskeletal Disorders |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12891-025-08934-z |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1849344275504955392 |
|---|---|
| author | Zhen Zhang Xiao-Dan Zhao Guanglin Wang Fuguo Huang |
| author_facet | Zhen Zhang Xiao-Dan Zhao Guanglin Wang Fuguo Huang |
| author_sort | Zhen Zhang |
| collection | DOAJ |
| description | Abstract Background Distal radius fractures are prevalent among the elderly. In cases of Gustilo I open distal radius fractures, standard initial management involves irrigation, debridement, reduction, and external fixation. Subsequently, external fixation may serve as the definitive treatment or transition to internal fixation. However, rare instances of fulminant necrotizing fasciitis and arterial embolization induced by Aeromonas hydrophila infection have been reported during the initial external fixation. Case presentation A 72-year-old healthy female with a Gustilo I open distal radius fracture underwent irrigation, debridement, reduction, and plaster placement. The patient experienced heightened pain, sensory loss, and arm swelling 8 hours later, and was then diagnosed with septic shock with Aeromonas hydrophila infection, necrotizing fasciitis, and arterial embolization 20 hours later. The patient received antibiotic administration and life-saving amputation. A vancomycin/gentamycin bone cement spacer was introduced into the void resulting from extensive debridement during the surgery. Postoperatively, the patient developed multiple organ dysfunction syndrome (MODS), which resolved within 5 days. Wound closure was subsequently performed in a second surgery, leading to a successful and robust recovery. Conclusions In managing open fractures among the elderly exposed to natural water sources, careful consideration is crucial due to the potential risk of anaerobic bacterial infection and necrotizing fasciitis associated with plaster or splint placement, creating a hypoxic environment. |
| format | Article |
| id | doaj-art-a1f9e743b10f49c5a2ad4ae7bf5c201b |
| institution | Kabale University |
| issn | 1471-2474 |
| language | English |
| publishDate | 2025-08-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Musculoskeletal Disorders |
| spelling | doaj-art-a1f9e743b10f49c5a2ad4ae7bf5c201b2025-08-20T03:42:41ZengBMCBMC Musculoskeletal Disorders1471-24742025-08-012611710.1186/s12891-025-08934-zAeromonas hydrophila-related fulminant necrotizing fasciitis and arterial embolization after plaster placement in Gustilo I distal radius fracture: a case report and literature reviewZhen Zhang0Xiao-Dan Zhao1Guanglin Wang2Fuguo Huang3Trauma Medical Center, Department of Orthopedic surgery, West China Hospital, Sichuan UniversityTrauma Medical Center, Department of Orthopedic surgery, West China Hospital, Sichuan UniversityTrauma Medical Center, Department of Orthopedic surgery, West China Hospital, Sichuan UniversityTrauma Medical Center, Department of Orthopedic surgery, West China Hospital, Sichuan UniversityAbstract Background Distal radius fractures are prevalent among the elderly. In cases of Gustilo I open distal radius fractures, standard initial management involves irrigation, debridement, reduction, and external fixation. Subsequently, external fixation may serve as the definitive treatment or transition to internal fixation. However, rare instances of fulminant necrotizing fasciitis and arterial embolization induced by Aeromonas hydrophila infection have been reported during the initial external fixation. Case presentation A 72-year-old healthy female with a Gustilo I open distal radius fracture underwent irrigation, debridement, reduction, and plaster placement. The patient experienced heightened pain, sensory loss, and arm swelling 8 hours later, and was then diagnosed with septic shock with Aeromonas hydrophila infection, necrotizing fasciitis, and arterial embolization 20 hours later. The patient received antibiotic administration and life-saving amputation. A vancomycin/gentamycin bone cement spacer was introduced into the void resulting from extensive debridement during the surgery. Postoperatively, the patient developed multiple organ dysfunction syndrome (MODS), which resolved within 5 days. Wound closure was subsequently performed in a second surgery, leading to a successful and robust recovery. Conclusions In managing open fractures among the elderly exposed to natural water sources, careful consideration is crucial due to the potential risk of anaerobic bacterial infection and necrotizing fasciitis associated with plaster or splint placement, creating a hypoxic environment.https://doi.org/10.1186/s12891-025-08934-zNecrotizing fasciitisAeromonas hydrophila infectionOpen distal radius fractureGustilo I |
| spellingShingle | Zhen Zhang Xiao-Dan Zhao Guanglin Wang Fuguo Huang Aeromonas hydrophila-related fulminant necrotizing fasciitis and arterial embolization after plaster placement in Gustilo I distal radius fracture: a case report and literature review BMC Musculoskeletal Disorders Necrotizing fasciitis Aeromonas hydrophila infection Open distal radius fracture Gustilo I |
| title | Aeromonas hydrophila-related fulminant necrotizing fasciitis and arterial embolization after plaster placement in Gustilo I distal radius fracture: a case report and literature review |
| title_full | Aeromonas hydrophila-related fulminant necrotizing fasciitis and arterial embolization after plaster placement in Gustilo I distal radius fracture: a case report and literature review |
| title_fullStr | Aeromonas hydrophila-related fulminant necrotizing fasciitis and arterial embolization after plaster placement in Gustilo I distal radius fracture: a case report and literature review |
| title_full_unstemmed | Aeromonas hydrophila-related fulminant necrotizing fasciitis and arterial embolization after plaster placement in Gustilo I distal radius fracture: a case report and literature review |
| title_short | Aeromonas hydrophila-related fulminant necrotizing fasciitis and arterial embolization after plaster placement in Gustilo I distal radius fracture: a case report and literature review |
| title_sort | aeromonas hydrophila related fulminant necrotizing fasciitis and arterial embolization after plaster placement in gustilo i distal radius fracture a case report and literature review |
| topic | Necrotizing fasciitis Aeromonas hydrophila infection Open distal radius fracture Gustilo I |
| url | https://doi.org/10.1186/s12891-025-08934-z |
| work_keys_str_mv | AT zhenzhang aeromonashydrophilarelatedfulminantnecrotizingfasciitisandarterialembolizationafterplasterplacementingustiloidistalradiusfractureacasereportandliteraturereview AT xiaodanzhao aeromonashydrophilarelatedfulminantnecrotizingfasciitisandarterialembolizationafterplasterplacementingustiloidistalradiusfractureacasereportandliteraturereview AT guanglinwang aeromonashydrophilarelatedfulminantnecrotizingfasciitisandarterialembolizationafterplasterplacementingustiloidistalradiusfractureacasereportandliteraturereview AT fuguohuang aeromonashydrophilarelatedfulminantnecrotizingfasciitisandarterialembolizationafterplasterplacementingustiloidistalradiusfractureacasereportandliteraturereview |