Free corticoperiosteal flap in the treatment of an infected bone defect of the tibia. A case report.
The treatment of septic bone defects represents a significant challenge in orthopaedic surgery. Non-vascularised cancellous bone grafts are very commonly used. In contrast, thin and malleable periosteal grafts have generally only been investigated in animal models. The free corticoperiosteal flap is used only in exceptional cases in traumatology. This case report describes the treatment of an infected and non-reactive bone defect in the shaft of the tibia. This case involves a septic non-union over two years old with evidence of methicillin-resistant Staph. aureus. A vascularised corticoperiosteal flap was used to bridge this defect. The procedure was supplemented by rigid internal fixation. There were no postoperative complications. Bone healing was documented eleven months after the described treatment. No further invasive procedures were required. The patient was able to return to his original occupation as a store manager. Stable internal fixation is an important precondition for successful treatment. The method described in this article can be considered for short defects when a conventional cancellous bone graft appears to be contraindicated.
Kaminski
Andrzej
A
Landeskrankenhaus Klagenfurt, Department of Traumatology, Klagenfurt, Austria. kaminski@t-online.de
Bürger
Heinz
H
Müller
Ernst Josef
EJ
D000328:Adult; D016025:Bone Transplantation / Q000379:methods; D005260:Female; D005593:Fracture Fixation, Internal / Q000379:methods*; D005599:Fractures, Ununited / Q000382:microbiology / Q000601:surgery*; D006801:Humans; D055624:Methicillin-Resistant Staphylococcus aureus; D013203:Staphylococcal Infections / Q000382:microbiology / Q000628:therapy*; D013524:Surgical Flaps; D013530:Surgical Wound Infection / Q000382:microbiology / Q000601:surgery*; D013978:Tibial Fractures / Q000382:microbiology / Q000601:surgery*; D016896:Treatment Outcome