Acta Medica Medianae
Vol. 51, No 2, June, 2012
UDK 61
ISSN 0365-4478(Printed version)
ISSN 1821-2794(Online)

Correspondence to:

Ivan Golubović

Clinic for Orthopaedics Surgery and Traumatology

Clinical Center Niš

Bul. dr Zorana Đinđića 48

18000 Niš, Serbia

E-mail:golubovicz@bankerinter.net

Case report                                             

UDC: 616-002.36:616.718.5-001.5-089.873                     

doi:10.5633/amm.2012.0205

GAS GANGRENE FOLLOWING AN OPEN TIBIAL FRACTURE - A CASE REPORT

Ivan Golubović¹, Predrag Stojiljković¹, Zoran Golubović^1,2, Goran Stevanović², Aleksandar Višnjić², Milan Trenkić², Danilo Stojiljković², Stevo Najman², Dragan Mihailović², Igor Kostić¹ and Miroslav Trajanović³

Orthopaedics and Traumatology Clinic, Clinical Center Niš, Serbia¹

University of Niš, Faculty of Medicine in Niš, Niš, Serbia²

University of Niš, Faculty of Mechanical Engineering, Niš, Serbia³

Gas gangrene is an invasive anaerobic infection, usually found in deep wounds with injury to large muscle masses that are contaminated with germs from the group of anaerobic clostridia. It is characterized by massive, acute progressive muscle necrosis and severe intoxication of the organism. The importance of gas gangrene is in its rapid evolution and high mortality. Untreated gas gangrene is fatal. This paper presents a patient in whom, after an open fracture of the femur and tibia, gas gangrene of the lower leg developed. Injury occurred during processing of agricultural land with a tiller, when cutter blades cut the bones of the leg and contaminated the wound with the soil in which clostridium microorganisms were present. After being admitted to hospital, due to lesions of the femoral vessels, hemostasis was performed, followed by the primary surgical treatment of the wound and external skeletal fixation. In the postoperative period, in the first 48 hours, there was a development of gas gangrene in the right calf with a bad general condition. For vital reasons, the patient underwent femoral amputation. Early amputation stump, after meticulous hemostasis was left open and was closed with the delayed secondary suture. After healing of the amputation stump, the patient was referred to physical therapy for prosthesis and gait training. Acta Medica Medianae 2012; 51(2):25-30.

      Key words: open fracture of the tibia, the external skeletal fixation, gas gangrene,

femoral amputation