Abstract
We present the case of a 29-year-old man who suffered an open supra-intercondylar femur fracture, treated with debridement, surgical scrub with saline solution, and stabilization by external fixator, and in a second stage with a definitive osteosynthesis, which after being washed with pressure gun presented abundant intramedullary gas non-related to infectious pathology but possibly related to a pulsatile jet lavage during surgery.
Highlights
The patient is a 29-year-old man with no history of interest, who was taken to our hospital on November 2015 approximately one hour after suffering a high energy traffic accident
On the right femur, we performed a resection of the wound edges according to Friederich, a debridement of the contaminating deep tissue and the fracture focus, manual wound cleaning with saline irrigation, and temporary fixation of the supracondylar fracture with an external fixator (Hoffman II, Synthes)
A favorable evolution of the soft tissues of the right femur, four days after the accident we did another manual wound cleaning with saline, a resection of the devitalized tissue, an open reduction (Figure 1C), and a definitive osteosynthesis with bicondylar cannulated screws and a plate (VA-Condylar, Synthes®, Figure 1D) through an anterolateral subvastus approach
Summary
The patient is a 29-year-old man with no history of interest, who was taken to our hospital on November 2015 approximately one hour after suffering a high energy traffic accident. Extensive wound cleaning was immediately performed at the emergency department, with manual irrigation using saline solution, as well as debridement of the most superficial contaminant material and temporary approximation of the wound edges.
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