title: Treatment of excessive bone loss from both crus bones with internal bone transport using an intramedullary nail. Case report.
abstract: We present a case report of a 16-year-old patient who suffered multisite and multiorgan injuries following a road accident. The most prominent musculoskeletal problem was a bilateral crush injury of the crus in combination with open fractures. The aim of this study is to present the possibilities and available methods of treatment of patients with extensive posttraumatic and postinflammatory bone loss of the lower limbs that make it possible to avoid amputation. We used intramedullary nailing and internal bone transport to reconstruct continuity and leg length of both crus bones. The treatment was complicated by poor vascularity and emerging complications. After several months and multi-stage treatment the patient was able to walk with full weight-bearing without crutches. Importantly, the patient is satisfied with the outcome of the treatment and does not consider herself disabled. The study presents our approach to the dilemma of choosing between prolonged reconstruction surgery and amputation as a final method.
authors.affiliation: Department of Orthopaedic and Trauma Surgery, Medical University of Silesia, Katowice, Poland. pberez@o2.pl
authors.forename: Przemysław
authors.initials: P
authors.lastname: Bereza
authors.forename: Piotr
authors.initials: P
authors.lastname: Wojciechowski
authors.forename: Damian
authors.initials: D
authors.lastname: Kusz
mesh_terms: D000063:Accidents, Traffic; D000293:Adolescent; D016025:Bone Transplantation / Q000379:methods*; D003131:Combined Modality Therapy; D005360:Fibula / Q000293:injuries / Q000601:surgery*; D005592:Fracture Fixation / Q000379:methods*; D005594:Fracture Fixation, Intramedullary / Q000379:methods*; D005597:Fractures, Open / Q000601:surgery*; D006801:Humans; D008297:Male; D013978:Tibial Fractures / Q000601:surgery*; D016896:Treatment Outcome