Cargando…
Combined Orthoplastic Approach in Fracture-Related Infections of the Distal Tibia
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 f...
Autores principales: | , , , , , , , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
MDPI
2022
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9414956/ https://www.ncbi.nlm.nih.gov/pubmed/36014058 http://dx.doi.org/10.3390/microorganisms10081640 |
_version_ | 1784776113754472448 |
---|---|
author | Sambri, Andrea Pignatti, Marco Tedeschi, Sara Lozano Miralles, Maria Elisa Giannini, Claudio Fiore, Michele Filippini, Matteo Cipriani, Riccardo Viale, Pierluigi De Paolis, Massimiliano |
author_facet | Sambri, Andrea Pignatti, Marco Tedeschi, Sara Lozano Miralles, Maria Elisa Giannini, Claudio Fiore, Michele Filippini, Matteo Cipriani, Riccardo Viale, Pierluigi De Paolis, Massimiliano |
author_sort | Sambri, Andrea |
collection | PubMed |
description | 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. |
format | Online Article Text |
id | pubmed-9414956 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | MDPI |
record_format | MEDLINE/PubMed |
spelling | pubmed-94149562022-08-27 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 Microorganisms Article 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. MDPI 2022-08-12 /pmc/articles/PMC9414956/ /pubmed/36014058 http://dx.doi.org/10.3390/microorganisms10081640 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/). |
spellingShingle | Article Sambri, Andrea Pignatti, Marco Tedeschi, Sara Lozano Miralles, Maria Elisa Giannini, Claudio Fiore, Michele Filippini, Matteo Cipriani, Riccardo Viale, Pierluigi De Paolis, Massimiliano Combined Orthoplastic Approach in Fracture-Related Infections of the Distal Tibia |
title | Combined Orthoplastic Approach in Fracture-Related Infections of the Distal Tibia |
title_full | Combined Orthoplastic Approach in Fracture-Related Infections of the Distal Tibia |
title_fullStr | Combined Orthoplastic Approach in Fracture-Related Infections of the Distal Tibia |
title_full_unstemmed | Combined Orthoplastic Approach in Fracture-Related Infections of the Distal Tibia |
title_short | Combined Orthoplastic Approach in Fracture-Related Infections of the Distal Tibia |
title_sort | combined orthoplastic approach in fracture-related infections of the distal tibia |
topic | Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9414956/ https://www.ncbi.nlm.nih.gov/pubmed/36014058 http://dx.doi.org/10.3390/microorganisms10081640 |
work_keys_str_mv | AT sambriandrea combinedorthoplasticapproachinfracturerelatedinfectionsofthedistaltibia AT pignattimarco combinedorthoplasticapproachinfracturerelatedinfectionsofthedistaltibia AT tedeschisara combinedorthoplasticapproachinfracturerelatedinfectionsofthedistaltibia AT lozanomirallesmariaelisa combinedorthoplasticapproachinfracturerelatedinfectionsofthedistaltibia AT gianniniclaudio combinedorthoplasticapproachinfracturerelatedinfectionsofthedistaltibia AT fioremichele combinedorthoplasticapproachinfracturerelatedinfectionsofthedistaltibia AT filippinimatteo combinedorthoplasticapproachinfracturerelatedinfectionsofthedistaltibia AT ciprianiriccardo combinedorthoplasticapproachinfracturerelatedinfectionsofthedistaltibia AT vialepierluigi combinedorthoplasticapproachinfracturerelatedinfectionsofthedistaltibia AT depaolismassimiliano combinedorthoplasticapproachinfracturerelatedinfectionsofthedistaltibia |