Management of a large post-traumatic skin and bone defect using an Ilizarov frame.
The authors report the case of a 28-year old male who presented with a compound diaphyseal fracture of the tibia, which was treated with intramedullary nailing. Postoperatively he required an extensive fasciotomy for an acute compartment syndrome. The fracture evolved towards post-traumatic osteomyelitis, growing methicillin-resistant Staphylococcus aureus (MRSA), combined with a large overlying soft tissue gap. An Ilizarov frame was used to treat both the bone and the skin defect. The infected fracture was treated by resection and longitudinal bone transport. Meanwhile, the skin was gradually closed using extra rods on the frame, allowing for a transverse 'skin transport'. Both the bone and the soft tissues healed without further complications.
D'Hooghe
Pieter
P
Department of Orthopaedics, University Hospital Pellenberg, Weligerveld 1, B-3212 Pellenberg, Belgium. pieter@medscape.com
Defoort
Koen
K
Lammens
Johan
J
Stuyck
Jos
J
D000328:Adult; D001842:Bone and Bones / Q000473:pathology*; D005594:Fracture Fixation, Intramedullary; D006801:Humans; D018889:Ilizarov Technique / Q000295:instrumentation*; D008297:Male; D012867:Skin / Q000473:pathology*; D013203:Staphylococcal Infections / Q000601:surgery; D013978:Tibial Fractures / Q000601:surgery; D014946:Wound Infection / Q000601:surgery