Limb salvage talectomy for 3C Gustilo–Anderson fracture

摘要

Foot fractures vary in severity with complex midfoot fractures having poor morbidity rates and high amputation rates. Complex midfoot fractures are rarely reported since they are uncommon and only treated in specialist centres. Given the important role of the midfoot in foot function, reconstruction is preferable. Soft tissue management on the dorsal aspect of the foot poses further challenges to reconstructive surgeons. We report a case of a 55-year-old woman who sustained an open 3C Gustilo–Anderson fracture that was initially treated with open reduction internal fixation and free flap. She subsequently developed flap and internal fixation failure with osteomyelitis of the talus. We report a good outcome using primary limb shortening with a talectomy, tibiocalcaneal arthrodesis using external fixation and a combination of vancomycin-loaded calcium sulphate and intravenous antibiotics in our patient.