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CASE REPORT
Management of large segmental tibial defects using locking IM nail and absorbable mesh
  1. Chris Whately1,
  2. Mohamed Attia Abdallah1,
  3. Yahya Ahmed Alwatari2
  1. 1MEDCARE Orthopaedics and Spine Hospital, Dubai, United Arab Emirates
  2. 2RCSI Medical University of Bahrain, Busaiteen, Bahrain
  1. Correspondence to Dr Chris Whately, chriswhately{at}hotmail.com

Summary

Tibia accounts for the majority of open fractures with long segmental defects. The management of such defects imposes several challenges due to their associations with extensive soft tissue damage and high infection risk. In this report, we describe a new technique for the reconstruction of tibia in a young patient with 10 cm defect. The patient had a history of Gustilo Anderson type IIIB open fracture following a motorcycle accident. He was initially managed with multiple debridements and application of an external fixator. The defect was treated with the insertion of an antibiotic-coated intramedullary nail along with posterolateral bone grafting using an absorbable mesh. Six months postoperative, radiological assessment showed excellent callus formation diffusely around the intramedullary nail along with optimal alignment. The preliminary follow-up data are quite encouraging and the technique described in our case can be considered as a reasonable option in managing long segmental bone defects.

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