case report

Reconstruction of Bone Loss in an Open Fracture of the Tibia with a Contralateral Free Tibial Graft: A Case Report and Outcome 10 Years Later

Sabri El Banna * , Serge Vandervelde, Olivier Delahaut

Department of Orthopedic and Traumatology affiliated to Brussel’s Free University, CHU de Charleroi (Hôpital Civil Marie Curie) 142, Chaussée de Bruxelles, 6042 LODELINSART, Belgium

*Corresponding author: Sabri El Banna, Department of Orthopedic and Traumatology affiliated to Brussel’s Free University, CHU de Charleroi (Hôpital Civil Marie Curie) 142, Chaussée de Bruxelles, 6042 LODELINSART, Belgium

Received Date: 12 December 2022

Accepted Date: 16 December 2022

Published Date: 19 December 2022

Citation: El Banna S, Vandervelde S, Delahaut O (2022) Reconstruction of Bone Loss in an Open Fracture of the Tibia with a Contralateral Free Tibial Graft: A Case Report and Outcome 10 Years Later. Ann Case Report. 7: 1093. DOI: https://doi.org/10.29011/25747754.101093

Abstract

We report the case of a 50-year-old man, worker on tracks at railway with a Gustillo grade IIIC fracture of the tibia. Management of bone and soft-tissue loss is described. The evolution and follow-ups with soft tissue and bone healing achieved with a contralateral tibial rod.

Keywords: Open fracture; Tibia; External fixator; Wound debridement; Contralateral tibial rod

Case Report

A 50-year-old man, worker on tracks at railway was victim of an accident during night shift on 05/26/2006 11:45 p.m. The patient seems to have passed under a railway. Arrival on site of the Emergency Resuscitation Mobile Unit (ERMU) who contacts the hospital for “leg amputation at the railway”. Immediate contact with the orthopedic surgeon who can be called back by the hospital. Arrival at the Emergency hospital 50 minutes after the accident. The patient is immediately directed to the operating room for surgical management within 30 minutes of arrival and 80 minutes from the time of the accident.

On clinical examination, the left lower limb was amputated almost completely over the entire middle 1/3 of the leg. However, a continuous posterior skin flap of 1/8th of the periphery of the leg was present (Figures 1-17). Distal pulses were absent, and the distal segment was cold. Neurological assessment was not possible at this stage.

 

Figure 1: A continuous posterior skin flap of 1/8th of the periphery of the leg was present.

 

Figure 2 : X-ray imaging shows a multifragmented fracture of the tibia and fibula.