Two months after the trauma, full elbow range of motion (ROM) was achieved. Splint was replaced with Sarmiento brace and the elbow movements were initiated.
After 5 days, patient was discharged with necessary post-operative instructions after graft site healing assurance.Īfter 20 days while full healing of the donor and graft sites were achieved, the sutures and splint were removed.
COMMINUTED OPEN FRACTURE PICTURES SKIN
Following the confirmation of absence of any infection and growth of the granulation tissue, patient was readmitted for skin graft. The patient was discharged and advised to use a 10-day vacuum dressing. The post-operative neurovascular tests were normal. Two titanium elastic nail (TEN) were inserted with rotational forces and anchored to the subchondral bone since the humeral head had a fracture. Afterwards, two small incisions were made over both epicondyles of humerus, and after awl insertion, fluoroscopic guided closed reduction of humerus was achieved by longitudinal traction, external rotation, and abduction. Through a deltopectoral approach, reduction of greater tubercle, anatomical neck and head-split component (about 20% of head) attained and were fixed by 3 screws. First, the wound was irrigated with low pressure pulsatile manner with more than 6 L of normal saline serum, followed by the debridement of the unviable tissues. Surgery was performed in semi-sitting position on the following day. To the best of our knowledge, no similar patient with such complex injuries has been described and treated with this approach in the literature, and the reported case and treatment approach in this study could help future cases and surgeons to achieve successful outcomes. In this study, we reported a patient with multifocal comminuted open fracture of humerus with severe soft tissue defect who was treated with and innovative approach using elastic medullary nailing and skin grafting to repair the humerus and soft tissue injury. Choosing the best treatment strategy for a multifocal comminuted open fracture of humerus associated with severe soft tissue defect and articular involvement is challenging, which could come up for every orthopedic surgeon specially for those working in trauma centers. Concomitance of severe soft tissue defect requiring soft tissue reconstruction with aforementioned injuries is scarce in literature. Coincidence of highly comminuted proximal and diaphyseal fracture makes these conditions even more complicated and challenging. In addition, head-split and anatomical neck humeral fractures are extremely rare. Bell said recovery would look like “months, not weeks” based on the initial release of information.Ipsilateral multifocal humeral fracture is an infrequent injury. Woods underwent his fifth back surgery in December and has previously had his spine fused. Los Angeles County Fire Chief Daryl Osby told reporters Tuesday that responders told him there were injuries to both legs, although the extent of the injuries to the left leg remains unknown. That is done to reduce nerve or blood vessel damage, Bell said, and is common during “high-energy” injuries, such as those suffered during a high-speed car accident.īell said Woods should be monitored for infection, which is always a potential issue for open wounds, but that doctors likely have him on antibiotics and thoroughly cleaned the area before and while caring for Woods.īell added that a trauma center usually prioritizes the most dire injuries, and that more surgeries could be required for the golfing legend. “They’re trying to get anatomical alignment.”įurthermore, trauma to nearby muscle and soft tissue required doctors to “surgically release” the muscle to reduce swelling. “Surgery takes a long time because they have to put the right tension on it, they have to reposition,” Bell said.
0 kommentar(er)
