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Journal of Medical Case Reports

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Open Access 01-12-2023 | Tibia Fracture | Case report

The successful treatment of a Gustilo–Anderson type IIIc distal leg injury with a large bone defect in elderly patient with severe osteoporosis: a case report

Authors: Koji Nozaka, Naohisa Miyakoshi, Motoki Mita, Yoichi Shimada

Published in: Journal of Medical Case Reports | Issue 1/2023

Abstract

Background

Gustilo–Anderson type IIIc tibial open fracture with large bone defects in elderly patients with severe osteoporosis is a rare injury that may be a challenging clinical scenario.

Case presentation

This study presents the case of a 68-year-old Japanese man who sustained a Gustilo–Anderson type IIIc open tibial fracture with a large bone defect. The patient had severe osteoporosis and the bone was contaminated; therefore, we determined that the bone could not be returned to the tibia. The patient underwent acute limb shortening and gradual lengthening with an Ilizarov external fixator combined with low-intensity pulsed ultrasound and teriparatide administration for limb reconstruction, which allowed immediate full weight-bearing capacity. The fixator was removed at 12 months postoperatively, and by this time, the fracture had completely healed. At the most recent 5-year follow-up after the injury, the patient reported full weight-bearing capacity without walking aids and had full knee and ankle range of motion.

Conclusions

To the best of our knowledge, this is the first study to report the use of combined Ilizarov technique, low-intensity pulsed ultrasound, and teriparatide for limb reconstruction of Gustilo–Anderson type IIIc open tibial fractures with large bone defects in elderly patients with severe osteoporosis.

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Title: The successful treatment of a Gustilo–Anderson type IIIc distal leg injury with a large bone defect in elderly patient with severe osteoporosis: a case report
Authors: Koji Nozaka
Naohisa Miyakoshi
Motoki Mita
Yoichi Shimada
Publication date: 01-12-2023
Publisher: BioMed Central
Keywords: Tibia Fracture
External Fixator
Osteoporosis
Osteoporosis
Bone Defect
Published in: Journal of Medical Case Reports / Issue 1/2023
Electronic ISSN: 1752-1947
DOI: https://doi.org/10.1186/s13256-023-04193-5

At a glance: The STEP trials

Springer Medicine

The successful treatment of a Gustilo–Anderson type IIIc distal leg injury with a large bone defect in elderly patient with severe osteoporosis: a case report

Abstract

Background

Case presentation

Conclusions

At a glance: The STEP trials

Springer Medicine

Abstract

Background

Case presentation

Conclusions

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