Introduction: The etiology of Klippel-Trenaunay syndrome (KTS) has a significant impact on the management of patient requiring surgical interventions. We report the strategies employed to address an infected non-union in a patient with KTS. Case Report: The patient was transported to an initial treating hospital with femoral shaft fracture after experiencing a fall. The patient was diagnosed with KTS due to vascular malformations identified after severe intraoperative hemorrhaging. An open reduction and internal fixation was performed to stabilize the bone. Nine months after surgery, the patient was transferred to our hospital due to lack of healing with infected non-union. We prioritized treating the infection and plate displacement, and subsequently performed intramedullary nailing. Infection and intraoperative hemorrhaging were successfully controlled and bone union was confirmed 6 months after surgery. Conclusion: The key factors to minimize procedural complications are sufficient preoperative evaluation and planning, surgical skill, and perioperative resource management.
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