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

AP View

Lateral

Skin Condition

Angiography

• No Flow middle portion of ATA, PTA & Peroneal

• Back filling from Collaterals

Extent of Infection - PET CT

Sequestrum

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

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

Debridement

Fixation

Postop

• Antibiotic Cement Spacer

• LRS Fixator

• Good Alignment

Evolution of Wound

6 Weeks Postop

• Infection Settled

• CRP normal• Bone Quality

Improved

Osteotomy

Bone Transport

Fixator Removal

Post Fixator Removal

Lateral

Skin Condition - Incison Through Graft

Function

Issues Remaining

• Equinus• Hind Foot Varus

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.

infected gap NU, poor skin

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Transcript of infected gap NU, poor skin

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