Open AccessRepair of an open forearm fracture and extensive bony loss (case report)
Author(s) -
Sh.M. Davirov,
Samarkand Orthopedics,
P.U. Urinboev
Publication year - 2021
Publication title -
genij ortopedii
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.141
H-Index - 3
eISSN - 2542-131X
pISSN - 1028-4427
DOI - 10.18019/1028-4427-2021-27-1-87-91
Subject(s) - intramedullary rod , medicine , forearm , surgery , ulna , avascular necrosis , fixation (population genetics) , external fixation , internal fixation , fibula , reduction (mathematics) , bone grafting , soft tissue , external fixator , tibia , population , geometry , environmental health , mathematics , femoral head
Repair of a double open comminuted fracture of forearm bones with extensive bony loss is challenging due to a high risk of infection and the need to address a significant bony defect. Neither internal fixation nor open reduction could be considered due to substantial bone loss and severely impaired circulation with a high risk of soft tissue necrosis and infection. We report staged management of forearm fracture using avascular autologous graft to repair the defect and maintain the forearm length. Objective Demonstrate the successful management of the double open comminuted fracture of forearm bones with extensive bony loss using Ilizarov external fixation, classical autologous grafting harvested from fibula and intramedullary (IM) nailing. Results and discussion The limb was temporarily fixed with Ilizarov frame in an extra-focal manner. An autogenous fibular graft of 11 cm was used to fill in the gap. Intramedullary nailing of the radius and ulna was produced and ulnar defect was repaired with autogenous fibular graft. IM nails were removed once the bones consolidated. The limb function was completely regained, anatomical length of the segment maintained and metal constructs removed. Conclusion Combination of different bone fixation modalities, classical autografting technique and intramedullary nailing provided complete recovery of the broken limb maintaining the function and bringing down the risk of complications to ensure a good clinical result.