Compound multifragmentary tibia # with infected enders nail
multifragmentary compound tibia #, tight stiched lower leg wound operated by someone (how could someone nail in such a bad wound) 10 days back, multiple flexible nail with ss wire applied, i was called to nail ipsilateral femur fracture, I removed all dead necrosed black skin removed stiches, debrided, bone nail and ss wire exposed with profuse pus coming, pt.yound lady 30 yrs, hepatitis +ve, i applied lower femoral steinmann pin traction, now planning to remove implant and apply ilizarov/ex fix....
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illizarov's will b nice option
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Deride first with removal of ender nail illizarove and dressing twice daily and culture from wound for proper antibiotic.
ReplyDeleteCulture of the pus. thorough debridement. Beeds pouch technique or vac dressing for the wound as u mentioned she is hep b positive minimal procedures for the long run will be advisable like ao fixators and let the wound heal well first and then use brace if still union is doubtful take a huge risk for ilizarov
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