Zuluaga Mauricio, Cadavid Sergio, Reina Federico, Reyes-Arceo Alma, Benedetti Fernando
Limb Lengthening and Reconstruction Unit, Clínica Imbanaco Grupo QuirónSalud, Cali, Colombia.
Faculty of Health Sciences, Pontificia Universidad Javeriana Cali, Colombia.
Trauma Case Rep. 2023 May 3;45:100834. doi: 10.1016/j.tcr.2023.100834. eCollection 2023 Jun.
The orthoplastic treatment of post-traumatic bone infections is complex and requires a multidisciplinary approach using both orthopedic and plastic surgery principles. Its primary goal is to achieve rapid control of the infection through aggressive debridement of the affected tissue, in order to perform a complete reconstruction of the limb. This allows both its salvage and restoration of function. We present a patient with septic non-union secondary to distal tibia fracture with a bone defect of 7 cm and severe soft tissue injury. The treatment was divided into three stages. First, the infection was controlled by radical debridement, limb shortening, and temporary stabilization. Second, early reconstruction was initiated utilizing the first stage of the Masquelet's induced membrane technique (MIMT), and soft tissue coverage with free flap. Third, MIMT was finalized, and bone lengthening with PRECICE nail was performed. We consider this approach effective as it can offer early recovery with optimal functional and aesthetic results in bone defects associated with coverage defects.
创伤后骨感染的矫形修复治疗复杂，需要采用骨科和整形外科原则的多学科方法。其主要目标是通过对受影响组织进行积极清创来迅速控制感染，以便对肢体进行全面重建。这既能挽救肢体，又能恢复其功能。我们介绍了一名因胫骨远端骨折继发感染性骨不连的患者，骨缺损7厘米，伴有严重软组织损伤。治疗分为三个阶段。首先，通过彻底清创、肢体缩短和临时固定来控制感染。其次，利用Masquelet诱导膜技术（MIMT）的第一阶段进行早期重建，并采用游离皮瓣进行软组织覆盖。第三，完成MIMT，并使用PRECICE钉进行骨延长。我们认为这种方法有效，因为它能在伴有覆盖缺损的骨缺损中实现早期恢复，并获得最佳的功能和美学效果。
