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- Title
Successful fifth metatarsal bulk autograft reconstruction of thermal necrosis post intramedullary fixation.
- Authors
Veljkovic, Andrea; Le, Vu; Escudero, Mario; Salat, Peter; Wing, Kevin; Penner, Murray; Younger, Alastair
- Abstract
Reamed intramedullary (IM) screw fixation for proximal fifth metatarsal fractures is technically challenging with potentially devastating complications if basic principles are not followed. A case of an iatrogenic fourth-degree burn after elective reamed IM screw fixation of a proximal fifth metatarsal fracture in a high-level athlete is reported. The case was complicated by postoperative osteomyelitis with third-degree soft-tissue defect. This was successfully treated with staged autologous bone graft reconstruction, tendon reconstruction, and local bi-pedicle flap coverage. The patient returned to competitive-level sports, avoiding the need for fifth ray amputation. Critical points of the IM screw technique and definitive reconstruction are discussed. Bulk autograft reconstruction is a safe and effective alternative to ray amputation in segmental defects of the fifth metatarsal.Level of evidence V.
- Subjects
INTRAMEDULLARY fracture fixation; IATROGENIC diseases; OSTEOMYELITIS; PATIENTS; AMPUTATION
- Publication
Knee Surgery, Sports Traumatology, Arthroscopy, 2020, Vol 28, Issue 5, p1595
- ISSN
0942-2056
- Publication type
journal article
- DOI
10.1007/s00167-018-4903-9