Articles | Volume 6, issue 3
https://doi.org/10.5194/jbji-6-63-2020
https://doi.org/10.5194/jbji-6-63-2020
Original full-length article
 | 
22 Dec 2020
Original full-length article |  | 22 Dec 2020

Simultaneous debridement, Ilizarov reconstruction and free muscle flaps in the management of complex tibial infection

Max Mifsud, Jamie Y. Ferguson, David A. Stubbs, Alex J. Ramsden, and Martin A. McNally

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Cited articles

BMJ: Best Practice Guideline for osteomyelitis, available at: https://bestpractice.bmj.com/topics/en-gb/354, last access: 20 May 2020. 
Bose, D., Kugan, R., Stubbs, D., and McNally, M.: Management of infected nonunion of the long bones by a multidisciplinary team, Bone Joint J., 97-B, 814–817, 2015. 
British Orthopaedic Association and British Association of Plastic, Reconstructive and Aesthetic Surgery: Open Fractures, available at: https://www.boa.ac.uk/resources/boast-4-pdf.html, last access: 6 May 2020. 
Chan, J. K., Harry, L., Williams, G., and Nanchahal, J.: Soft-tissue reconstruction of open fractures of the lower limb: muscle versus fasciocutaneous flaps, Plast Reconstr Surg., 130, 284e–295e, https://doi.org/10.1097/PRS.0b013e3182589e63, 2012. 
Chan, J., Ferguson, J., Scarborough, M., McNally, M., and Ramsden, A.: Management of Post-traumatic Osteomyelitis in the Lower Limb: Current State of the Art, Ind. J. Plast. Surg., 52, 62–72, https://doi.org/10.1055/s-0039-1687920, 2019. 
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Chronic bone infections often present with major bone and soft tissue loss which can be difficult to manage. In this study, we treated the most complex infections using surgery which reconstructed all of the tissues in one operation. We showed that this was a safe approach with very good outcomes. All of the bones healed and 96.5 % of patients were infection-free at final follow-up. This type of surgery requires close cooperation of a multidisciplinary team with expertise in major infections.
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