Early Post-Traumatic Van Nes Rotationplasty After an Open Femur Fracture With a Necrotizing Soft-Tissue Infection: A Case Report.

JBJS Case Connect

Department of Orthopaedic Surgery, Harbor-University of California, Los Angeles, Medical Center, Torrance, California.

Published: November 2021


Category Ranking

98%

Total Visits

921

Avg Visit Duration

2 minutes

Citations

20

Article Abstract

Case: A 26-year-old man presented after an automobile versus pedestrian accident with a Type IIIA open femur fracture complicated by a necrotizing soft-tissue infection (NSTI) with significant bone loss. Multiple limb-preserving operations failed, including the placement of a plate-assisted, motorized lengthening intramedullary nail with a chimeric free flap. We describe the patient's successful definitive treatment with a Van Nes rotationplasty (VNR). The patient currently ambulates independently with a prosthesis and is without recurrent infection after 3 years of follow-up.

Conclusion: VNR is a potential strategy to avoid transfemoral amputation or hip disarticulation in open femur fractures complicated by NSTI.

Download full-text PDF

Source
http://dx.doi.org/10.2106/JBJS.CC.21.00470DOI Listing

Publication Analysis

Top Keywords

open femur
12
van nes
8
nes rotationplasty
8
femur fracture
8
necrotizing soft-tissue
8
soft-tissue infection
8
early post-traumatic
4
post-traumatic van
4
rotationplasty open
4
fracture necrotizing
4

Similar Publications

Background: Cervical vertebral maturation (CVM) is a skeletal maturity method that can be assessed routinely on whole spine radiographs to minimize radiation exposure. Originally used in orthodontics, its role in staging adolescent growth spurt and curve progression in adolescent idiopathic scoliosis (AIS) remains unclear. The aim of this study was to investigate growth rates across CVM stages, its cutoff for indicating peak growth (PG) versus growth cessation (GC), and its relationship with coronal curve progression.

View Article and Find Full Text PDF

Background: In robotic-assisted total knee arthroplasty (RA-TKA), the femoral prosthesis is positioned independent of the intramedullary canal and frequently in flexion for function optimization. Femoral prosthesis flexion displaces retrograde intramedullary nail (rIMN) start point posteriorly potentially exacerbating hyperextension deformity in periprosthetic fracture (PPFx) fixation. The aim of this study was to determine the relationship between RA-TKA femoral component flexion with rIMN sagittal trajectory angulation.

View Article and Find Full Text PDF

Introduction/background: Complex articular fractures around the knee in the elderly patient present an ongoing challenge regarding optimal treatment. While extensive research has evaluated immediate arthroplasty following fracture of the proximal femur, distal femur, proximal humerus, and elbow, relatively little focus has been given to immediate arthroplasty following complex tibia plateau fractures.

Methods: As seen with many other fractures, arthroplasty can shorten recovery and hospital stay and allow early weight-bearing with improved mobility while minimizing complications and possible future conversion arthroplasty cost.

View Article and Find Full Text PDF

Gaucher disease (GD) is an inherited lysosomal storage disorder caused by glucocerebrosidase (GCase) deficiency. A 35-year-old male patient was admitted to our hospital due to left thigh pain and restricted mobility for 10 h. Following comprehensive evaluations, the patient was diagnosed with GD complicated by a pathological fracture of the left femur.

View Article and Find Full Text PDF

Osteochondromas are the most common benign bone tumors and are frequently discovered incidentally in the metaphyseal regions of long bones during growth. While typically asymptomatic, they may occasionally lead to complications such as neurovascular impingement, mechanical irritation, or pathological fractures. Salter-Harris type II fractures represent the most frequent physeal injuries in pediatric populations, particularly in rapidly growing regions like the distal femur.

View Article and Find Full Text PDF