COMPLEX TRAUMA OF THE LIMBS “LIMB AND LIFE THREATENING INJURIES”

T.C. Munteanu1, D. Zamfirescu1,3, M. Nagea 2, A. Dimitriu 2, N.Ciurea 2, Olivera Lupescu1,2

1The University of Medicine and Pharmacy “Carol Davila”, Bucharest, Romania
2Orthopedic and Traumatology Clinic, The Emergency Clinical Hospital, Bucharest, Romania
3Plastic Surgery and Reconstructive Microsurgery Clinic, The Emergency Clinical Hospital, Bucharest, Romania


Corresponding author: Tiberiu-Ciprian Munteanu
Phone no. 0040748207070
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Abstract

Complex limb trauma are extremely severe and pose a threat both to the patient’s life, because of their systemic impact, as well as to the vitality of the traumatized limb, because of potentially severe septic complications. Post-traumatic (post fracture) osteitis is most often a consequence of an open fracture (always contaminated) or a closed operated fracture which was contaminated by pathogenic germs, the most common of which is Staphylococcus aureus (but Gram-negative bacteria, such as Klebsiella, Pseudomonas and Proteus are also worth mentioning). The consequence of an acute osteitis which was incompletely or inadequately treated is chronic osteitis, which requires long-term treatment, with inconsistent outcome results. To describe this topic, we present the case of a 15 year old pacient, which presents at the hospital as a surgical emergency, following a complex high energy trauma cause by a smash-up, whose survival and then healing, in spite of complete and correct approach, were extremely problematic/challenging, and called for a massive amount of human, financial and temporal resources.

Keywords: crushing injury, haemoragic shock, osteitis, debridement, vascular graft, pluridisciplinary team

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