Infected Nonunion: Tibia Case 5

Presenting

This 47 year old gentleman was working at a machine shop when a part came off the machine at a high velocity and impacted his left tibia. This massive blow resulted in a severe left open tibia fracture. This patient was treated at an outside facility with a spanning external fixator, serial irrigation and debridements and soft tissue coverage.

Several months later the patient presented to see Dr. Brinker with gross purulent drainage and a severely infected tibial nonunion.

Treatment in Progress

Following aggressive debridement of infected and necrotic bone, Dr. Brinker performed Ilizarov external fixation with a double level transport. The red rectangle illustrates the bony defect; the green arrow shows the proximal corticotomy site with early new bone formation; the red arrow shows the distal corticotomy site with early new bone formation.

Result After Treatment by Dr. Brinker

Final radiographs show solid healing of both corticotomy sites and the midshaft docking site. The patient is pain free, infection free, can ambulate fully weight bearing without aides, and has returned to full duty at the machine shop.