Successful treatment of infected wound dehiscence after minimally invasive locking-plate osteosynthesis of tibial pilon and calcaneal fractures by plate preservation, surgical debridement and antibiotics

Giandavide Ieropoli, Jorge Hugo Villafañe, Silvia Chiara Zompi, Umberto Morozzo, Riccardo D'Ambrosi, Federico Giuseppe Usuelli, Pedro Berjano

Research output: Contribution to journalArticlepeer-review

Abstract

Objective The aim is to present a case series that illustrates possible benefits from combining minimally invasive plate osteosynthesis (MIPO), plastic surgery and antibiotic therapy, in order to treat and eradicate infection in patients with tibial pilon or calcaneal fractures. Methods Eleven consecutive patients with dehiscence of the surgical wound in outcomes MIPO using a Locking Compression Plate (LCP) for tibial pilon, or calcaneus fractures. The patients had developed a documented infection of the surgical wound. All patients were treated and followed-up by the multidisciplinary team with the orthopedic surgeon, the plastic surgeon and the infectious disease physician. All patients were followed by the plastic surgeon to treat the wound dehiscence, as well as by the orthopedic surgeon until fracture consolidation. The duration of the antibiotic therapy was from 4 to 6 months. After 6 weeks, the intravenous treatment was replaced by oral administration. The follow-up intervals were 15 days, 40 days, and 3 months. Results The average time of wound closure was 109 ± 60 days. The antibiotics used were chosen according to the antibiogram. The antibiotic therapy had a duration of 4–6 months, and after 6 weeks, the therapy switched to oral administration. At the 3-month follow-up, all patients had excellent outcomes and had returned to their normal activity of daily living. Conclusion The patients in this study responded positively to a combination of MIPO, plastic surgery and antibiotic therapy, confirming that multidisplinary treatment in association with titanium devices are able to eradicate infection in short time.

Original languageEnglish
Pages (from-to)44-47
Number of pages4
JournalFoot
Volume33
DOIs
Publication statusPublished - Dec 1 2017

Keywords

  • Calcaneaus
  • Foot
  • Fractures
  • Infected wound
  • Minimally invasive plate osteosynthesis
  • Osteosynthesis
  • Tibial pilon

ASJC Scopus subject areas

  • Podiatry
  • Orthopedics and Sports Medicine

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