Staged limb salvage of a Gustilo–Anderson type IIIC open distal tibial gunshot fracture using cross-leg pedicle flap and delayed intramedullary nailing with bone grafting: a case report - Summary - MDSpire
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Staged limb salvage of a Gustilo–Anderson type IIIC open distal tibial gunshot fracture using cross-leg pedicle flap and delayed intramedullary nailing with bone grafting: a case report
To report a case of Gustilo–Anderson type IIIC open fracture of the distal tibia caused by a gunshot injury and to describe the staged management approach, highlighting its significance in clinical practice.
Approach:
Key Findings:
The patient regained full weight-bearing ability and independent ambulation at six months post-injury.
Cross-leg pedicle flaps are a reliable option for soft-tissue coverage in resource-limited settings.
Staged management including vascular repair, debridement, and soft-tissue coverage can lead to successful limb salvage.
Interpretation:
A staged treatment strategy combining vascular repair, repeated debridement, cross-leg flap reconstruction, and delayed intramedullary fixation with bone grafting is presented as a potential approach for limb salvage in selected patients with severe open tibial gunshot injuries.
Limitations:
The case study is based on a single patient, limiting generalizability.
Resource constraints may affect the applicability of the described techniques in different settings.
Conclusion:
A staged approach is presented as a method to manage severe open tibial fractures with vascular injury, particularly in resource-constrained environments.
Teriparatide followed by zoledronic acid increased bone mineral density but did not reduce fracture risk compared with standard care in adults with osteogenesis imperfecta.
