Management of a Complex Lower Limb Open Fracture in a Teenage Patient: A Case Report.

Management of a Complex Lower Limb Open Fracture in a Teenage Patient: A Case Report. Ostomy Wound Manage. 2018 May;64(5):47-52 Authors: Mijatović D, Orehovec SS, Đapić T, Vrbanović Mijatović V, Mance M Abstract The challenges of managing Gustilo IIIB tibial fractures (ie, high energy trauma with a contaminated wound >10 cm in length, severe comminution ["crumbling"] or segmental fractures, and periosteal stripping) in children are unique in part because no clear guidelines exist and the injuries may cause short-term and long-term complications. Repeated wound debridement and secondary reconstruction are required in approximately 20% of these cases in both adults and children. A 13-year-old girl presented with severe polytrauma including an open Gustilo type IIIB fracture of the left lower leg. The patient declined limb amputation; a multidisciplinary team (plastic, pediatric, orthopedic-trauma surgeons, pediatrician, psychiatrist, clinical pharmacologist, anesthesiologist, physiotherapist, nurses) was assembled in order to give the patient the best chance of a successful outcome. Multiple limb salvage and reconstructive procedures including wound debridements, necrectomies, long-term negative pressure wound therapy, soft tissue reconstructions, external bone fixation, bone osteosynthesis, multiple skin grafts, and free-flap reconstruction were provided over a period of 6 months with great success. The patient is doing well 3...
Source: Ostomy Wound Management - Category: Surgery Tags: Ostomy Wound Manage Source Type: research