Abstract text (incl. references and figure legends)
Introduction Fracture related infection (FRI) is a serious complication of surgical fracture treatment. Intra-articular fractures of distal tibia are often a result of high energy trauma, sufficient debridement produce bone and soft tissue defect, which requires the involvement of a plastic surgeon.
Methods In our retrospective study we have treated ten consecutive patients, who have required segmental resection of distal tibia and the articular surface of the upper ankle joint. The average bone defect was nine centimetres. The soft tissue coverage is essential for the treatment of infection and bone healing, it had to be addressed first. The bone transport method with external fixator was used for the bone defect treatment. The goal was to achieve tibio-talar bone union. Fig1
Results We observed some pintrack infection, in one case with a progression to the bone, additional surgery was necessary. We have had the arthrodesis healing problems in three patients and distraction callus in two. Both the arthrodesis and the distraction callus can be bridged and fixed by a long retrograde nail. Fig2
Conclusion Bone transport is a surgical treatment for bone defect produced by segmental resection in order to heal infection. It is challenging for patients to maintain an external fixator for a longer period, therefore the possibility of early removal and additional surgery providing another type of fixation needs to be considered. Plastic surgeon involvement is crucial. It is essential that all possible treatments are put forward in the primary care of the injury to prevent infection, or to act quickly and correctly in the event of the early infection occurring regardless.
References Metsemakers,W.J(2018).Infection after fracture fixation:Current surgical and microbiological concepts.Injury,49(3),511–522. McNally,M(2017). Ilizarov Treatment Protocols in the Management of Infected Nonunion of the Tibia.Journal of Orthopaedic Trauma,31,S47–S54.
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