Tibia Fracture in Staged Limb Salvage Using External Ring Fixation and Intramedullary Nailing: A Report of Two Cases

Abstract

Limb salvage for Charcot's neuroarthropathy has been shown to have high complication and failure rates. The aim of our report of two cases it to present a unique complication encountered with staged limb salvage for Charcot's neuroarthropathy. In two cases, patients developed delayed tibial shaft fracture associated with previous wire placement despite insertion of locked intramedullary nail fixation that spanned the delayed fracture. Both patients experienced fractures following advancement of weight after definitive fixation. In both patients, there was noted complication with the sites of the pins and revision of external fixation before fracture. In each case, the fracture was within the construct of the intramedullary fixation and successfully treated with an extended course of nonweightbearing. Complications of external fixation and intramedullary fixation are well reported within the literature; however, tibia fracture is rare. Based on these cases, it would seem prudent to recognize the risk of delayed pin-site complications and ensure adequate length of intramedullary fixation to span the potential areas of stress.

Comparison of the Effects of Intramedullary Nailing and Plate Fixation on Lower-Extremity Deep Vein Thrombosis after Tibial Fractures

“…As one of the most common fracture types in clinic, tibial fracture causes significant damage to the lower limbs as well as a significant reduction of lowerextremity joint and bone function [17]. At present, postfracture internal fixation, as the best treatment for fractures, is commonly used in two types: PF and IMN [18]. However, the effect of the two methods on tibial fractures is still controversial, and their impacts on postoperative lowerextremity DVT remain undefined.…”

Effect of the Holistic Nursing Model of Responsibility System on the Mental State of Elderly Patients with Limb Fractures Fixed by Splints in the Emergency Department

“…In order to promote the rapid physical rehabilitation of elderly patients with limb fractures, clinicians often provide targeted treatment and postoperative rehabilitation nursing services according to the type, degree, and course of the fracture. Among them, traditional Chinese splint fxation has the advantages of simple operation, convenient economy, and a remarkable therapeutic efect and has been widely used in clinical practice [3,4]. However, elderly patients need long-term bed rest after fracture, and the gastrointestinal and metabolic systems are disordered, increasing the psychological pressure and physiological needs of patients.…”