Abstract
The patient was a 76-year-old woman who twisted her left ankle, resulting in an open fracture-dislocation of the left ankle joint. She underwent temporary external fixation surgery, followed by open reduction and internal fixation on the 13th day post-injury. However, the wound dehisced at both the medial and lateral malleoli six days after surgery, and by four weeks postoperatively, the plate had become exposed. Following debridement under general anesthesia, negative pressure wound therapy with instillation and dwelling（NPWTi-d）was initiated. One week later, granulation tissue was observed in the screw hole of the plate. To promote further granulation, two screws were subsequently removed. Five weeks after the introduction of NPWTi-d, the plate was completely covered with granulation tissue. By eight weeks postoperatively, the wound had fully epithelialized. Few studies have reported the use of NPWT for exposed plates in anatomically challenging areas with limited soft tissue coverage such as the ankle joint. In the present case, we observed granulation tissue originating from the screw hole fusing with granulation at the wound edge, resulting in coverage of the plate. This pattern of granulation may facilitate epithelialization during plate preservation.
