Exposure of the tibia and fibula
This is a severe injury resulting from a road traffic accident in a Sub-Saharan African country, with incomplete initial management. The patient was only able to be transferred to our institution in Tangier three months after the accident.
There was an infected loss of skin and tendon tissue with exposure of the tibia and fibula over a length of 18 centimeters. These bone segments were infected.
The treatment was carried out in several stages:
Resection of the sequestrated bone fragments.
Skin graft
Extensive necrosectomy was performed, followed by limb shortening with marked hyper-dorsiflexion of the foot to allow bone coverage.
A free skin graft was subsequently carried out.
Proximal tibial osteotomy performed to initiate lengthening.
Rehabilitation with assisted walking using a walker.
Union of both the regenerate bone and the fracture was achieved, with a lengthening of 4 cm.
Wound healing and eradication of the infection.
Such results can only be achieved through a relationship built on trust, perseverance, and considerable sacrifice.