This series reports on the treatment of distal tibia (DT) fracture-related infections (FRI) with a combined orthoplastic approach. Thirteen patients were included. In eight patients with extensive bone involvement and in those with a non-healed fracture, the DT was resected ("staged approach"). In five cases, the DT was preserved ("single-stage approach"). A wide debridement was performed, and the cavity was filled with antibiotic-loaded PerOssal beads. All patients had a soft-tissue defect covered by a free vascularized flap (anterolateral thigh perforator flap in eight cases, latissimus dorsi flap in five). At the final follow-up (mean 25 months, range, 13-37), no infection recurrence was observed. In one patient, the persistence of infection was observed, and the patient underwent a repeated debridement. In two cases, a voluminous hematoma was observed. However, none of these complications impacted the final outcome. The successful treatment of FRI depends on proper debridement and obliteration of dead spaces with a flap. Therefore, when dealing with DT FRI, debridement of infected bone and soft tissues must be as radical as required, with no fear of the need for massive reconstructions.

Combined Orthoplastic Approach in Fracture-Related Infections of the Distal Tibia / Sambri, Andrea; Pignatti, Marco; Tedeschi, Sara; Lozano Miralles, Maria Elisa; Giannini, Claudio; Fiore, Michele; Filippini, Matteo; Cipriani, Riccardo; Viale, Pierluigi; De Paolis, Massimiliano. - In: MICROORGANISMS. - ISSN 2076-2607. - ELETTRONICO. - 10:8(2022), pp. 1640-1649. [10.3390/microorganisms10081640]

Combined Orthoplastic Approach in Fracture-Related Infections of the Distal Tibia

Sambri, Andrea;Pignatti, Marco;Tedeschi, Sara;Lozano Miralles, Maria Elisa;Giannini, Claudio;Viale, Pierluigi;
2022

Abstract

This series reports on the treatment of distal tibia (DT) fracture-related infections (FRI) with a combined orthoplastic approach. Thirteen patients were included. In eight patients with extensive bone involvement and in those with a non-healed fracture, the DT was resected ("staged approach"). In five cases, the DT was preserved ("single-stage approach"). A wide debridement was performed, and the cavity was filled with antibiotic-loaded PerOssal beads. All patients had a soft-tissue defect covered by a free vascularized flap (anterolateral thigh perforator flap in eight cases, latissimus dorsi flap in five). At the final follow-up (mean 25 months, range, 13-37), no infection recurrence was observed. In one patient, the persistence of infection was observed, and the patient underwent a repeated debridement. In two cases, a voluminous hematoma was observed. However, none of these complications impacted the final outcome. The successful treatment of FRI depends on proper debridement and obliteration of dead spaces with a flap. Therefore, when dealing with DT FRI, debridement of infected bone and soft tissues must be as radical as required, with no fear of the need for massive reconstructions.
2022
Combined Orthoplastic Approach in Fracture-Related Infections of the Distal Tibia / Sambri, Andrea; Pignatti, Marco; Tedeschi, Sara; Lozano Miralles, Maria Elisa; Giannini, Claudio; Fiore, Michele; Filippini, Matteo; Cipriani, Riccardo; Viale, Pierluigi; De Paolis, Massimiliano. - In: MICROORGANISMS. - ISSN 2076-2607. - ELETTRONICO. - 10:8(2022), pp. 1640-1649. [10.3390/microorganisms10081640]
Sambri, Andrea; Pignatti, Marco; Tedeschi, Sara; Lozano Miralles, Maria Elisa; Giannini, Claudio; Fiore, Michele; Filippini, Matteo; Cipriani, Riccardo; Viale, Pierluigi; De Paolis, Massimiliano
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11585/895771
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