infected gap NU, poor skin

Center for Limb Lengthening & Reconstruction, MumbaiCenter for Limb Lengthening & Reconstruction, Mumbai

Advised amputation came to us as a ‘last resort’

• 23 yr old male• RTA• Grade IIIC compound fracture distal

1/3rd Tibia• Neurovascular Injury• Exfix, LD Flap & Skin Grafts, Multiple

Debridements• 3 Toes amputated• 9 months - Infected Nonunion

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AP View

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Lateral

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Skin Condition

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Angiography

• No Flow middle portion of ATA, PTA & Peroneal

• Back filling from Collaterals

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Extent of Infection - PET CT

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Sequestrum

• Incise Grafted areas straight to bone and raise as a sleeve

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Center for Limb Lengthening & Reconstruction, MumbaiCenter for Limb Lengthening & Reconstruction, Mumbai 8


Debridement

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Fixation

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Postop

• Antibiotic Cement Spacer

• LRS Fixator

• Good Alignment

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Evolution of Wound

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6 Weeks Postop

• Infection Settled

• CRP normal• Bone Quality

Improved

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Osteotomy

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Bone Transport

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Fixator Removal

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Post Fixator Removal

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Lateral

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Skin Condition - Incison Through Graft

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Function

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Issues Remaining

• Equinus• Hind Foot Varus

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Center for Limb Lengthening & Reconstruction, Mumbai

• equinus has since been corrected using a six axis (Ortho-SUV)

• Unfortunately the video cannot be put on slideshare.

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infected gap NU, poor skin

Health & Medicine

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