Arthroscopic Subtalar Arthrodesis after a Calcaneus Fracture Covered with a Forearm Flap英文文献资料.docVIP

HindawiPublishingCorporation MinimallyInvasiveSurgery Volume2011,ArticleID930902,3pages doi:10.1155/2011/930902 CaseReport ArthroscopicSubtalarArthrodesisafter aCalcaneusFractureCoveredwithaForearmFlap FrederickMichels, FilipStockmans, St′ephaneGuillo, JanVanDerBauwhede, 1 1 2 1 andDirkOosterlinck 1 1 2 DepartmentofOrthopaedics,AZGroeninge,BurgemeesterVercruysselaan5,8500Kortrijk,Belgium DepartmentofOrthopaedics,BordeauxM′erignacSportsClinic,9,rueJeanMoulin,33700M′erignac,France CorrespondenceshouldbeaddressedtoFrederickMichels,frederick michels@ Received15September2010;Accepted21December2010 AcademicEditor:OthmarSch¨ob Copyright?2011FrederickMichelsetal. This is an open access article distributed under the Creative CommonsAttribution License,whichpermitsunrestricteduse,distribution,andreproductioninanymedium,providedtheoriginalworkisproperly cited. Surgicaltreatmentofintraarticularcalcanealfracturesisoftenassociatedwithpostoperativewoundproblems.Softtissuenecrosis, bonelossanduncontrollableinfectionareachallengeforthesurgeonandamputationmayinsomecasesbetheultimatesolution. Afree?apcanbeveryhelpfultocoverasigni?cantsofttissuedefectandhelpin?ghtingtheinfection.However,thefree?ap complicatesthesurgicalapproachifsubtalararthrodesisandbonereconstructionareneeded.Thisstudydemonstratesthevalue ofanarthroscopictechniquetoresecttheremainingarticularcartilageinpreparationforsubtalararthrodesisandbonegrafting. Thisapproachavoidscompromisingthesofttissuesandminimizesdamagetothefree?ap. 1.Introduction After two weeks of elevation, an osteosynthesis was performed. Oneweekpostoperatively,serousdrainageand erythema occurred and were treated with oral antibiotics and local wound care. Several weeks later serous drainage persistedoriginatingfromtheapexoftheL-shapedincision. Surgical debridementsand vacuum-assisted closure (VAC) wereusedforseveralweekstopromotewoundhealing. Finallyanosteomyelitiswithsigni?cantavascular