Osteocutaneous thermal necrosis of the leg salvaged by TSF/Ilizarov reconstruction. Report of 7 patients
Open Access
- 23 February 2010
- journal article
- research article
- Published by Springer Science and Business Media LLC in International Orthopaedics
- Vol. 35 (1), 121-126
- https://doi.org/10.1007/s00264-010-0952-5
Abstract
Injudicious reaming of the tibial shaft can lead to extreme local hyperthermia, which in turn can result in the rare but catastrophic complication of segmental bone and soft tissue necrosis (osteocutaneous thermal necrosis). This is a retrospective study showing osteocutaneous thermal necrosis occurring after tibial intramedullary reaming salvaged by Ilizarov reconstruction in seven patients from the collective experience of four limb reconstruction centres. All patients were males, with an average age of 51.8 years (range, 30–70 years), who had undergone intramedullary reaming during the treatment of closed tibial fractures. In all patients, circumferential bone and variable contiguous soft tissue necrosis developed a few days after reaming. Bone and soft tissue reconstruction was subsequently performed using a circular external fixator (Ilizarov apparatus or Taylor spatial frame) a mean of four months after injury in six patients; in one case, reconstruction was undertaken four years after the original injury. Two complications (secondary tissue breakdown at a bone transport site; premature consolidation) necessitated cessation of bone transport at one of two bone transport levels in two patients. All patients eventually healed with a good functional result after an average of 11.5 months in the fixator (range, 10–13 months).Keywords
This publication has 18 references indexed in Scilit:
- Thermal tibial osteonecrosis: A diagnostic challenge and review of the literatureInjury, 2010
- Correction of post-traumatic lower limb deformities using the Taylor spatial frameInternational Orthopaedics, 2009
- Thermal Necrosis Complicating Reamed Intramedullary Nailing of a Closed Tibial Diaphysis Fracture: A Case ReportJournal of Orthopaedic Trauma, 2008
- Distraction osteogenesis in management of composite bone and soft tissue defectsInternational Orthopaedics, 2008
- The Thermal Effects of Intramedullary ReamingJournal of Orthopaedic Trauma, 2004
- The Influence of the Size and Condition of the Reamers on Bone Temperature During Intramedullary ReamingThe Journal of Bone & Joint Surgery, 2004
- The assessment of cortical heat during intramedullary reaming of long bonesInjury, 2001
- Intramedullary pressure, strain on the diaphysis and increase in cortical temperature when reaming the femoral medullary cavity — a comparison of blunt and sharp reamersInjury, 1993
- Ilizarov Treatment of Tibial Nonunions With Bone LossPublished by Ovid Technologies (Wolters Kluwer Health) ,1989
- Heat of Intramedullary ReamingSouthern Medical Journal, 1987