Treatment of Infection After Tibial Intramedullary Nailing With Bone Distraction Combined With Free Anterolateral Thigh Flap for Concomitant Soft-tissue Defect
Summary:. A 57-year-old man presented with a tibial shaft fracture treated with tibial intramedullary nail fixation and plate and screw fixation for fibular fracture. Two weeks postoperatively, the patient developed skin sloughing with exposed bone and metal at the fracture site. Three weeks postope...
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| Main Authors: | , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Wolters Kluwer
2024-12-01
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| Series: | Plastic and Reconstructive Surgery, Global Open |
| Online Access: | http://journals.lww.com/prsgo/fulltext/10.1097/GOX.0000000000006346 |
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| author | Zhegang Zhou, MD Haotian Qin, PhD Abdelhakim Ezzat Marei, MD Jingjing Wen, MD Longbiao Yu, MD Fanbin Meng, MD Tao Zhou, MD Yingfeng Xiao, MD Hui Zeng, PhD Fei Yu, PhD |
| author_facet | Zhegang Zhou, MD Haotian Qin, PhD Abdelhakim Ezzat Marei, MD Jingjing Wen, MD Longbiao Yu, MD Fanbin Meng, MD Tao Zhou, MD Yingfeng Xiao, MD Hui Zeng, PhD Fei Yu, PhD |
| author_sort | Zhegang Zhou, MD |
| collection | DOAJ |
| description | Summary:. A 57-year-old man presented with a tibial shaft fracture treated with tibial intramedullary nail fixation and plate and screw fixation for fibular fracture. Two weeks postoperatively, the patient developed skin sloughing with exposed bone and metal at the fracture site. Three weeks postoperatively, a physical examination revealed swelling of the left lateral malleolus and lower leg, a skin defect of approximately 3 × 5 cm2 at the lower third of the left tibia with an exposed fracture site and hardware in between the fracture fragments. The patient underwent debridement, removal of the intramedullary nail, vacuum sealing drainage, removal of the fibular plate, repositioning, and application of an external fixator. Antibiotic-impregnated bone cement was applied at the fracture site. One week postoperatively, the medullary canal was debrided, and a free anterolateral thigh flap was designed to repair the skin defect. Approximately 5 cm of the opposed fracture fragments was removed from the tibia, and antibiotic-calcium sulfate bone substitutes were applied to the fracture site. Definitive fixation was obtained by a circular external fixation and a minimally invasive osteotomy of the proximal tibia was performed. The patient had no recurrence of infection, and his limb function has recovered well. |
| format | Article |
| id | doaj-art-d16c2066367548c3b5e4870c64d51f28 |
| institution | Kabale University |
| issn | 2169-7574 |
| language | English |
| publishDate | 2024-12-01 |
| publisher | Wolters Kluwer |
| record_format | Article |
| series | Plastic and Reconstructive Surgery, Global Open |
| spelling | doaj-art-d16c2066367548c3b5e4870c64d51f282024-12-24T09:46:25ZengWolters KluwerPlastic and Reconstructive Surgery, Global Open2169-75742024-12-011212e634610.1097/GOX.0000000000006346202412000-00024Treatment of Infection After Tibial Intramedullary Nailing With Bone Distraction Combined With Free Anterolateral Thigh Flap for Concomitant Soft-tissue DefectZhegang Zhou, MD0Haotian Qin, PhD1Abdelhakim Ezzat Marei, MD2Jingjing Wen, MD3Longbiao Yu, MD4Fanbin Meng, MD5Tao Zhou, MD6Yingfeng Xiao, MD7Hui Zeng, PhD8Fei Yu, PhD9From the * Department of Hand and Microsurgery, Peking University Shenzhen Hospital, Shenzhen, China† Department of Bone and Joint Surgery, Peking University Shenzhen Hospital, Shenzhen, China¶ Orthopedic Surgery Department, Tanta University Hospital, Tanta, EgyptFrom the * Department of Hand and Microsurgery, Peking University Shenzhen Hospital, Shenzhen, ChinaFrom the * Department of Hand and Microsurgery, Peking University Shenzhen Hospital, Shenzhen, ChinaFrom the * Department of Hand and Microsurgery, Peking University Shenzhen Hospital, Shenzhen, ChinaFrom the * Department of Hand and Microsurgery, Peking University Shenzhen Hospital, Shenzhen, ChinaFrom the * Department of Hand and Microsurgery, Peking University Shenzhen Hospital, Shenzhen, China∥ Department of Orthopedics, Shenzhen Second People’s Hospital, Shenzhen, China.† Department of Bone and Joint Surgery, Peking University Shenzhen Hospital, Shenzhen, ChinaSummary:. A 57-year-old man presented with a tibial shaft fracture treated with tibial intramedullary nail fixation and plate and screw fixation for fibular fracture. Two weeks postoperatively, the patient developed skin sloughing with exposed bone and metal at the fracture site. Three weeks postoperatively, a physical examination revealed swelling of the left lateral malleolus and lower leg, a skin defect of approximately 3 × 5 cm2 at the lower third of the left tibia with an exposed fracture site and hardware in between the fracture fragments. The patient underwent debridement, removal of the intramedullary nail, vacuum sealing drainage, removal of the fibular plate, repositioning, and application of an external fixator. Antibiotic-impregnated bone cement was applied at the fracture site. One week postoperatively, the medullary canal was debrided, and a free anterolateral thigh flap was designed to repair the skin defect. Approximately 5 cm of the opposed fracture fragments was removed from the tibia, and antibiotic-calcium sulfate bone substitutes were applied to the fracture site. Definitive fixation was obtained by a circular external fixation and a minimally invasive osteotomy of the proximal tibia was performed. The patient had no recurrence of infection, and his limb function has recovered well.http://journals.lww.com/prsgo/fulltext/10.1097/GOX.0000000000006346 |
| spellingShingle | Zhegang Zhou, MD Haotian Qin, PhD Abdelhakim Ezzat Marei, MD Jingjing Wen, MD Longbiao Yu, MD Fanbin Meng, MD Tao Zhou, MD Yingfeng Xiao, MD Hui Zeng, PhD Fei Yu, PhD Treatment of Infection After Tibial Intramedullary Nailing With Bone Distraction Combined With Free Anterolateral Thigh Flap for Concomitant Soft-tissue Defect Plastic and Reconstructive Surgery, Global Open |
| title | Treatment of Infection After Tibial Intramedullary Nailing With Bone Distraction Combined With Free Anterolateral Thigh Flap for Concomitant Soft-tissue Defect |
| title_full | Treatment of Infection After Tibial Intramedullary Nailing With Bone Distraction Combined With Free Anterolateral Thigh Flap for Concomitant Soft-tissue Defect |
| title_fullStr | Treatment of Infection After Tibial Intramedullary Nailing With Bone Distraction Combined With Free Anterolateral Thigh Flap for Concomitant Soft-tissue Defect |
| title_full_unstemmed | Treatment of Infection After Tibial Intramedullary Nailing With Bone Distraction Combined With Free Anterolateral Thigh Flap for Concomitant Soft-tissue Defect |
| title_short | Treatment of Infection After Tibial Intramedullary Nailing With Bone Distraction Combined With Free Anterolateral Thigh Flap for Concomitant Soft-tissue Defect |
| title_sort | treatment of infection after tibial intramedullary nailing with bone distraction combined with free anterolateral thigh flap for concomitant soft tissue defect |
| url | http://journals.lww.com/prsgo/fulltext/10.1097/GOX.0000000000006346 |
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