title: A Gustilo type IIIB open forearm fracture treated by negative pressure wound therapy and locking compression plates: a case report.
abstract: A 91-year-old female sustained injuries to her left forearm while walking across a crosswalk. X-rays showed left radial shaft and ulna shaft fractures, and the injury was a type IIIB open fracture. On the day of admission, irrigation and debridement of the open wound, and temporary fixation of the radius and ulna using an external fixator and a Kirschner wire were peformed. Six days after the surgery, we used negative pressure wound therapy (NPWT) using the V.A.C.ATS system for the open wound. Thirteen days after the first surgery, definitive fixation was performed by using locking compression plates, and full thickness skin grafting was undertaken for the open wound. NPWT is a treatment that accelerates the wound healing process through the delivery of continuous subatmospheric pressure within a closed environment. In our case, we could reduce the healing period of the soft tissue and could convert to the definitive fixation in a timely fashion. NPWT is thought to be a useful adjunct in the management of the soft tissues of open fractures.
authors.affiliation: Department of Orthopaedic Surgery, Saga Prefectural Hospital Koseikan, Saga, Japan. kaonao@ceres.ocn.ne.jp
authors.forename: Naohide
authors.initials: N
authors.lastname: Takeuchi
authors.forename: Takao
authors.initials: T
authors.lastname: Mae
authors.forename: Shunsuke
authors.initials: S
authors.lastname: Hotokezaka
authors.forename: Kosuke
authors.initials: K
authors.lastname: Sasaki
authors.forename: Akinobu
authors.initials: A
authors.lastname: Matsushita
authors.forename: Go
authors.initials: G
authors.lastname: Miake
authors.forename: Rintaro
authors.initials: R
authors.lastname: Kuchiishi
authors.forename: Yasuo
authors.initials: Y
authors.lastname: Noguchi
mesh_terms: D000369:Aged, 80 and over; D001860:Bone Plates; D005260:Female; D005593:Fracture Fixation, Internal / Q000295:instrumentation*; D005597:Fractures, Open / Q000628:therapy*; D006801:Humans; D054843:Negative-Pressure Wound Therapy; D011885:Radius Fractures / Q000628:therapy*; D014458:Ulna Fractures / Q000628:therapy*