Literature DB >> 23355597

Catastrophic osteomyelitis following percutaneous wire fixation of a distal radial fracture: a cautionary tale of poor patient selection followed by surgical mishap.

David W Shields1, David W Elson, Martin Marsh, Andrew C Gray.   

Abstract

We present a case of distal radius fracture. Several sequential unfortunate events resulted in a poor outcome. The patient was poorly selected because the degree of early dementia was not fully appreciated, due to intermittent periods of lucidity. Having elected to treat this distal radius fracture with Kirschner wires, a wire snapped during the procedure and was deemed safe to leave within the medullary cavity. Subsequently, the patient was left in a cast for 4 weeks without regular pin site inspection. When the cast was removed a gross osteomyelitis had developed. This series of events, led to unnecessary morbidity and extended the immobilisation time with reduced wrist function. This case highlights the importance of careful patient selection, surgical tactics and continuity of care.

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Year:  2013        PMID: 23355597      PMCID: PMC3604556          DOI: 10.1136/bcr-2012-008425

Source DB:  PubMed          Journal:  BMJ Case Rep        ISSN: 1757-790X


  5 in total

1.  Human error: models and management.

Authors:  J Reason
Journal:  BMJ       Date:  2000-03-18

Review 2.  Bacterial adhesion: seen any good biofilms lately?

Authors:  W Michael Dunne
Journal:  Clin Microbiol Rev       Date:  2002-04       Impact factor: 26.132

3.  Two procedures for Kirschner wire osteosynthesis of distal radial fractures. A randomized trial.

Authors:  P C Strohm; C A Müller; T Boll; U Pfister
Journal:  J Bone Joint Surg Am       Date:  2004-12       Impact factor: 5.284

4.  [Osteosynthesis using intra-focal pins of anteriorly dislocated fractures of the inferior radial epiphysis].

Authors:  G Hoël; A I Kapandji
Journal:  Ann Chir Main Memb Super       Date:  1995
  5 in total

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