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19 Feb 2023
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Staged debridement, transport and nailing of an open distal tibia with critical bone defect

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Clinical Details

Clinical and radiological findings:  22 years old - traffic accident - exposed tibia fracture. Initial extra-institutional management with OSTEOSINTHESIS with a fibula plate and damage control in the tibia - poor evolution of soft tissues - infection of soft and bone tissues - joint destruction

Preoperative Plan

Planning remarks:  Reconstruction in stages

Surgical Discussion

Operative remarks: 

Removal of material - Oncological debridement - TPN - Cement pearls with Antibiotic. Replenishment of fixer away from coverage defect. Acute shortening in Ilizarov external fixation deformity. Correction of progressive deformity - lengthening of soft tissues. Replacement of external fixator - ILIZAROV - bifocal OSTEOTOMY - bone lengthening and transport for purposes of warm distal ARTHRODESIS. Conversion to antibiotic release tibia nail after cleaning the medullary canal with the RIA system. Non-union in the distal tibia area of ARTHRODESIS. Removal of material - Cleaning and stimulation of non-union with morphogenetic protein - Fixation with ARTRODESIS nail.

Orthopaedic implants used:   Reconstruction and salvage of limbs Bone elongation Bone infections - Cel 3162908676

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Jhon Perez Casado
  • Colombia , Cali - Valle del Cauca
  • Area of Specialty - Lower Limb
  • Position - Specialist Consultant
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