Open Tibial Fracture in a Non-Compliant Patient: A Case Report

Journal of Functional Morphology and Kinesiology

Testa, Gianluca¹  Pizzolo, Samuele² 

[1] Author to whom correspondence should be addressed;Department of General Surgery and Medical Surgical Specialties, Section of Orthopaedics and Traumatology, AOU Policlinico-Vittorio Emanuele, University of Catania, Via Plebiscito 628, 95100 Catania, Italy

关键词: open tibial fracture;    Gustilo–Anderson classification;    compliance;    intramedullary nailing;    external fixation;   

DOI  :  10.3390/jfmk3030044

学科分类：力学，机械学

来源: mdpi

【 摘 要 】

Open tibial fractures represent the most frequent fractures of long bones, comprising approximately 1.9% of all fractures. Although locked intramedullary nailing is the gold standard for treating closed and unstable tibia diaphyseal fractures, for most exposed fractures, an external fixator can first be used, followed by conversion through an intramedullary nail. The present report describes the case of a 17-year-old male who presented with a complex multi-segmented displaced tibia fracture, type 42-C3, with exposure of IIIB type according to the Gustilo–Anderson classification, and with an attached disrupted fracture of peroneal malleolus, type 44-B2. External fixation was the preferred treatment method. Before the definitive surgical treatment, the patient had a second accident that caused refracture and damage to the soft tissues and external fixation system. This prolonged the time estimated for the conversion from the external fixator to the intramedullary nail. The reported case shows the use of various treatment steps with different timelines and an intervention with vacuum-assisted closure therapy for soft tissue healing as well as subsequent intramedullary nailing in order to reach the definitive healing of a non-compliant patient. These combined methods achieved an acceptable reduction and good stability of such a complex fracture.

【 授权许可】

CC BY