Abstract:
:Limb salvage in fungal osteomyelitis of the post-traumatic lower extremity represents a difficult clinical problem requiring aggressive management. We report lower extremity salvage by radical bony debridement, free tissue transfer, distraction osteogenesis with bone-docking, and a novel antifungal regimen in a clinical setting of infection with Scedosporium inflatum, historically requiring amputation in 100% of cases. We treated Scedosporium inflatum osteomyelitis of the tibia and calcaneus with radical debridement of infected bone, free partial medial rectus abdominis muscle flap coverage, transport distraction osteogenesis, and combination voriconazole/terbinafine chemotherapy, a novel antifungal regimen. We achieved successful control of the infection, limb salvage, and an excellent functional outcome through aggressive debridement of infected bone and soft tissue, elimination of dead space within the bony defect, the robust perfusion provided by the free flap, the hypervascular state induced by distraction osteogenesis, and the synergism of the novel antifungal regimen.
journal_name
Microsurgeryjournal_title
Microsurgeryauthors
Cetrulo CL Jr,Leto Barone AA,Jordan K,Chang DS,Louie K,Buntic RF,Brooks Ddoi
10.1002/micr.20956subject
Has Abstractpub_date
2012-02-01 00:00:00pages
144-7issue
2eissn
0738-1085issn
1098-2752journal_volume
32pub_type
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