Atypical osteogenesis following multiple sequestrectomies for infected open fracture of the femur: a case
Chevalley, F.; Livio, J.J.; Blanc, C.H.
Revue de Chirurgie Orthopedique et Reparatrice de l'Appareil Moteur 76(4): 280-283
1990
ISSN/ISBN: 0035-1040 PMID: 2148407 Document Number: 362705
The authors present the case of an open fracture of femur Cauchoix type II with an infection due to Escherichia coli, Clostridium perfringens, Enterococcus and Aspergillus fumigatus. After several sequestrectomies and five hyperbaric sessions, apyrexia was attained at the end of the third month, the femur having been stabilised with an external fixator. The 15 cm gap due to loss of bone substance, filled at each dressing with an antiseptic iodine based ointment, closed itself finishing as continuous bone five months after the accident, the granulation tissue having been recovered by thin skin grafts. A repeated fracture occurring forty-eight hours after the removal of the Hoffmann frame was treated by fitting an Ilizarov fixator arriving at consolidation in seven months. The authors examine different possibilities of accelerating osteogenesis and highlight the potential role of iodine ointment as inductive to osteogenesis stemming from a periosteal layer seemingly held in place.