Persistent Infection in a Patient with Tibial Non-union
Keywords:Pin site infections, Tibial fractures, Ilizarov technique, Non-union
This report presents a case of persistent pin site infection that resulted in the removal of hardware in a patient who underwent Ilizarov stabilization for compound tibial fractures. Despite antibiotics, the infection worsened, necessitating removal of the entire Ilizarov frame to prevent permanent damage or non-union. Bone marrow stimulators were subsequently placed for healing support. The report emphasizes the importance of rigorous pin site care, meticulous monitoring, low threshold for diagnosis of complications and swift escalation of treatment when needed. However, vigilance alone may not be enough, especially in those with co-morbidities, open injuries or hardware applications simplifying opportunities for nosocomial infection. The patient's recovery process involved early, optimized rehabilitation, medical and social supports, leading to a return to partial mobility and function despite a prolonged recovery process. Diligent follow-up was necessary at each stage to recognize complications before permanent damage and revise treatment plans as needed. The report aims to share lessons learned and strengthen preparedness for future cases facing similar challenges. Success emerged from determination, vigilance and partnership. Close monitoring makes the difference between catastrophic loss and maximal benefit from an ordeal already threatened by overcoming disability.
Gebhard F, Huber-Lang M. Polytrauma-pathophysiology and management principles. Langenbeck’s archives of surgery. 2008; 393: 825–31.
Cancienne JM, Burrus MT, Weiss DB, Yarboro SR. Applications of local antibiotics in orthopedic trauma. Orthopedic Clinics. 2015; 46(4):495–510.
Thakore RV, Greenberg SE, Shi H, Foxx AM, Francois EL, Prablek MA, et al. Surgical site infection in orthopedic trauma: a case–control study evaluating risk factors and cost. Journal of clinical orthopaedics and trauma. 2015; 6(4):220–6.
Gage MJ, Liporace FA, Egol KA, McLaurin TM. Management of bone defects in orthopedic trauma. Bulletin of the NYU Hospital for Joint Diseases. 2018; 76(1):4–8.
Walaszek M, Zie?czuk W, Wolak Z, Dobro? W. Surgical site infections in patients of orthopedic-trauma unit in district hospital in 2008-2012. Przeglad Epidemiologiczny. 2013; 67(3):439–44.
Busse JW, Morton E, Lacchetti C, Guyatt GH, Bhandari M. Current management of tibial shaft fractures: a survey of 450 Canadian orthopedic trauma surgeons. Acta orthopaedica. 2008; 79(5):689–94.
Tang PF, Hou ZY, Wu XB, Zhang CQ, Wang JW, Xing X, et al. Expert consensus on management principles of orthopedic emergency in the epidemic of coronavirus disease 2019. Chinese medical journal. 2020; 133(09):1096–8.
Wixted JJ, Reed M, Eskander MS, Millar B, Anderson RC, Bagchi K, et al. The effect of an orthopedic trauma room on after-hours surgery at a level one trauma center. Journal of orthopaedic trauma. 2008; 22(4):234–6.
Kenley RA, Yim K, Abrams J, Ron E, Turek T, Marden LJ, et al. Biotechnology and bone graft substitutes. Pharmaceutical research. 1993; 10:1393–401.
Li RH, Wozney JM. Delivering on the promise of bone morphogenetic proteins. Trends in biotechnology. 2001; 19(7):255–65.
Vasconez HC, Nicholls PJ. Management of extremity injuries with external fixator or Ilizarov devices: cooperative effort between orthopedic and plastic surgeons. Clinics in plastic surgery. 1991; 18(3):505–13.
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