2025 Volume 38 Issue 2 Pages 53-56
For Gustilo typeⅢB open fractures, early flap coverage is recommended to prevent infection. We report a case of a Gustilo typeⅢB open tibial fracture with ipsilateral hip fracture-dislocation and distal femur fracture that had a good outcome after staged treatment. The patient, a 54-year-old male, was injured in a traffic accident and diagnosed with right hip fracture-dislocation, right distal femur fracture, and open right tibial fracture. Emergency debridement of the wound, external fixation of the fracture, reduction of the hip dislocation, and traction were performed. Pelvic osteosynthesis was performed on day 6, and that of the femur and tibia on day 9. A free anterolateral thigh flap was performed on day 17. Ten months post-injury, the patient was able to walk without pain, and bone union was achieved. In this case, we considered performing early free-flap surgery to prevent infection of the open tibial fracture. However, to promote rehabilitation, we first treated the pelvic fracture and repeated wound debridement. Although a free flap was performed on day 17, infection did not occur, and good results were obtained.
