Nonunion After an Open Trimalleolar Ankle Fracture: An Extended Clinical Course and a Novel Approach to Tibio-Talo-Calcaneal Arthrodesis.
Masquelet
bone graft reconstruction
chronic osteomyelitis
low-grade infection
reamer-irrigator-aspirator
ring-fixator
salvage procedure
tibio-talo-calcaneal arthrodesis
Journal
The Journal of foot and ankle surgery : official publication of the American College of Foot and Ankle Surgeons
ISSN: 1542-2224
Titre abrégé: J Foot Ankle Surg
Pays: United States
ID NLM: 9308427
Informations de publication
Date de publication:
Historique:
received:
15
08
2019
revised:
24
03
2020
accepted:
29
03
2020
pubmed:
10
1
2021
medline:
25
6
2021
entrez:
9
1
2021
Statut:
ppublish
Résumé
Nonunion in the setting of chronic osteomyelitis after severe open ankle fractures is a feared outcome with severe loss in patient quality of life. Tibio-talo-calcaneal arthrodesis is a good salvage treatment option in this difficult patient cohort. We report a case of chronic osteomyelitis with severe destruction of the ankle joint after failed fracture fixation of an open trimalleolar ankle fracture. Fusion was ultimately achieved 5 years later using a novel-staged Masquelet technique with external ring fixator stabilization and bone graft reconstruction including femoral harvested autograft using reamer-irrigator-aspirator. This case shows that infection free arthrodesis of the ankle can be achieved even years after failed treatment. This procedure restored significant quality of life through pain relief and much improved mobility and may be a helpful technique in complex tibio-talo-calcaneal arthrodesis in the setting of chronic osteomyelitis and significant joint destruction.
Identifiants
pubmed: 33419648
pii: S1067-2516(20)30277-5
doi: 10.1053/j.jfas.2020.03.025
pii:
doi:
Types de publication
Case Reports
Langues
eng
Sous-ensembles de citation
IM
Pagination
378-381Informations de copyright
Copyright © 2020 the American College of Foot and Ankle Surgeons. Published by Elsevier Inc. All rights reserved.