Salvage of open tibial fracture with segmental loss of tibial nerve: case report and review of the literature.
We report a case history, treatment, and follow-up of an open comminuted distal tibial fracture with significant soft tissue loss and segmental loss of the tibial nerve and posterior tibial artery. This constellation of injuries with an insensate plantar foot has often been an indication for amputation. In this instance, a functional distal extremity was salvaged with the use of Ilizarov fixation, delayed primary tibial nerve cable grafting, and staged soft tissue coverage. Clinical follow-up and review of the literature on the techniques used are offered for consideration.
Higgins
T F
TF
Department of Orthopaedics and Rehabilitation, Yale University School of Medicine, New Haven, Connecticut 06511, USA.
DeLuca
P A
PA
Ariyan
S
S
D000063:Accidents, Traffic; D000328:Adult; D016267:External Fixators; D005260:Female; D005500:Follow-Up Studies; D017102:Fracture Healing / Q000502:physiology; D005597:Fractures, Open / Q000175:diagnosis / Q000534:rehabilitation / Q000601:surgery*; D006801:Humans; D018889:Ilizarov Technique; D015601:Injury Severity Score; D013524:Surgical Flaps; D013978:Tibial Fractures / Q000175:diagnosis / Q000534:rehabilitation / Q000601:surgery*; D013979:Tibial Nerve / Q000293:injuries / Q000601:surgery*; D016896:Treatment Outcome; D014945:Wound Healing / Q000502:physiology