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 - Takeaways - MDSpire

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

  • By

  • Abdikarim Mahad Ahmed

  • Osman Mohamed Abdulkarim

  • Abdijalil Abdullahi Ali

  • Mohamed Osman Dahir Alasow

  • Nur Adam Mohamed

  • Abdullahi Khalif Ali

  • June 11, 2026

  • 0 min

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  • 1

    A 25-year-old man sustained a Gustilo–Anderson type IIIC open tibial fracture from a gunshot injury, requiring urgent vascular repair.

  • 2

    Initial management included irrigation, debridement, arterial repair, and temporary external fixation to stabilize the injury.

  • 3

    Soft-tissue coverage was achieved using a cross-leg pedicle flap after serial debridements resulted in a clean wound.

  • 4

    Delayed intramedullary nailing was performed after soft-tissue healing, supported by a fibular strut graft and bone grafting.

  • 5

    At six months post-injury, the patient demonstrated progressive healing and regained full weight-bearing ability with good functional recovery.

Original Source(s)

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

  • by Abdikarim Mahad Ahmed, Osman Mohamed Abdulkarim, Abdijalil Abdullahi Ali, Mohamed Osman Dahir Alasow, Nur Adam Mohamed, Abdullahi Khalif Ali

  • June 11, 2026

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