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Case report
Complete ejection of a ring sequestrum 8 years after external fixation of the tibia
  1. Isabella Regina Timmer1,
  2. Benjamin Lucas Emmink1,2,
  3. Loek Petrus Hendrikus Leenen1 and
  4. Geertje Anna Maria Govaert1
  1. 1Department of Trauma Surgery, University Medical Center Utrecht, Utrecht, The Netherlands
  2. 2Department of Trauma Surgery, Haaglanden Medical Centre, The Hague, The Netherlands
  1. Correspondence to Dr Benjamin Lucas Emmink; bemmink{at}


On the day of scheduled debridement for a persistent pin tract infection, a 23-year old man presented himself carrying a small bony ring sequestrum that had spontaneously ejected from his tibial wound 1 week earlier. Eight years prior to presentation, he was treated for an open crural fracture which was stabilised with an external fixator. Revision of the operation notes revealed that the placement of this external fixator was performed without predrilling.

  • infections
  • trauma
  • bone and joint infections
  • orthopaedics

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  • Contributors All authors contributed equally to the manuscript. IRT is the primary author responsible for the writing and collection of literature. BLE, LPHL and GAMG directly supervised the study and were responsible for the literature review. GAMG is the treating physician.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.