Department of Orthopaedic Surgery, Harbor-University of California, Los Angeles, Medical Center, Torrance, California.
JBJS Case Connect. 2021 Nov 4;11(4):01709767-202112000-00039. doi: e21.00470.
A 26-year-old man presented after an automobile versus pedestrian accident with a Type IIIA open femur fracture complicated by a necrotizing soft-tissue infection (NSTI) with significant bone loss. Multiple limb-preserving operations failed, including the placement of a plate-assisted, motorized lengthening intramedullary nail with a chimeric free flap. We describe the patient's successful definitive treatment with a Van Nes rotationplasty (VNR). The patient currently ambulates independently with a prosthesis and is without recurrent infection after 3 years of follow-up.
VNR is a potential strategy to avoid transfemoral amputation or hip disarticulation in open femur fractures complicated by NSTI.
一名 26 岁男性，因车祸致股骨开放性骨折（III 型 A 型），伴坏死性软组织感染（NSTI）和严重骨质丢失。该患者曾经历多次保肢手术失败，包括使用钢板辅助、电动延长髓内钉和嵌合游离皮瓣等治疗方法。我们成功地对该患者实施了 Van Nes 旋转成形术（VNR），对其进行了确定性治疗。随访 3 年后，患者目前可独立使用假肢行走，且无感染复发。
在伴有 NSTI 的开放性股骨骨折中，VNR 是避免股骨截肢或髋关节离断的一种潜在策略。
