title: Spontaneous healing of a massive tibial cortical defect.
abstract: This case report describes the spontaneous healing of a 20-cm massive tibial cortical defect. The defect was created during debridement of necrotic bone and soft tissue in a low-velocity gunshot wound of the tibia that became infected in a skeletally mature patient. The patient was treated in an external fixator and had a soleus flap to provide soft-tissue coverage. He had refused any surgical reconstructive options. Despite the absence of surgical reconstruction, his tibia healed, and he returned to full activity without any orthotic device 9 months after the original injury.
authors.affiliation: Department of Orthopaedics, Kings County Hospital Center, Brooklyn, New York, USA.
authors.forename: D M
authors.initials: DM
authors.lastname: Klein
authors.forename: D A
authors.initials: DA
authors.lastname: Caligiuri
authors.forename: J
authors.initials: J
authors.lastname: Riina
authors.forename: B M
authors.initials: BM
authors.lastname: Katzman
mesh_terms: D000293:Adolescent; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D017102:Fracture Healing / Q000502:physiology*; D005599:Fractures, Ununited / Q000000981:diagnostic imaging / Q000503:physiopathology*; D006801:Humans; D018889:Ilizarov Technique; D008297:Male; D011859:Radiography; D012075:Remission, Spontaneous; D016868:Serratia Infections / Q000175:diagnosis / Q000503:physiopathology / Q000628:therapy*; D013290:Streptococcal Infections / Q000175:diagnosis / Q000503:physiopathology / Q000628:therapy*; D013524:Surgical Flaps; D013530:Surgical Wound Infection / Q000175:diagnosis / Q000503:physiopathology / Q000628:therapy*; D013977:Tibia / Q000000981:diagnostic imaging / Q000503:physiopathology*; D013978:Tibial Fractures / Q000000981:diagnostic imaging / Q000209:etiology / Q000503:physiopathology*; D014948:Wounds, Gunshot / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*
chemical_list: D000900:Anti-Bacterial Agents