Srpski arhiv za celokupno lekarstvo 2013 Volume 141, Issue 9-10, Pages: 693-697
https://doi.org/10.2298/SARH1310693G
Full text ( 485 KB)
Cited by
Treatment of open tibial fracture with bone defect caused by high velocity missiles: A case report
Golubović Zoran (Klinički centar, Klinika za ortopediju i traumatologiju, Niš + Medicinski fakultet, Niš)
Vukašinović Zoran (Institut za ortopedsku hirurgiju „Banjica“, Beograd + Medicinski fakultet, Beograd)
Stojiljković Predrag (Klinički centar, Klinika za ortopediju i traumatologiju, Niš)
Golubović Ivan (Klinički centar, Klinika za ortopediju i traumatologiju, Niš)
Višnjić Aleksandar (Medicinski fakultet, Niš)
Radovanović Zoran (Medicinski fakultet, Niš)
Najman Stevo (Medicinski fakultet, Niš)
Introduction .Tibia fracture caused by high velocity missiles is mostly
comminuted and followed by bone defect which makes their healing process
extremely difficult and prone to numerous complications. Case Outline. A
34-year-old male was wounded at close range by a semi-automatic gun missile.
He was wounded in the distal area of the left tibia and suffered a massive
defect of the bone and soft tissue. After the primary treatment of the wound,
the fracture was stabilized with an external fixator type Mitkovic, with
convergent orientation of the pins. The wound in the medial region of the
tibia was closed with the secondary stitch, whereas the wound in the lateral
area was closed with the skin transplant after Thiersch. Due to massive bone
defect in the area of the rifle-missile wound six months after injury, a
medical team placed a reconstructive external skeletal fixator type Mitkovic
and performed corticotomy in the proximal metaphyseal area of the tibia. By
the method of bone transport (distractive osteogenesis), the bone defect of
the tibia was replaced. After the fracture healing seven months from the
secondary surgery, the fixator was removed and the patient was referred to
physical therapy. Conclusion. Surgical treatment of wounds, external
fixation, performing necessary debridement, adequate antibiotic treatment and
soft and bone tissue reconstruction are essential in achieving good results
in patients with the open tibial fracture with bone defect caused by high
velocity missiles. Reconstruction of bone defect can be successfully treated
by reconstructive external fixator Mitkovic.
Keywords: high velocity missiles, tibial fracture, bone defect, reconstructive external fixator Mitkovic
Projekat Ministarstva nauke
Republike Srbije, br. III 41017 i br. III 41004