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Case Reports
. 2020 Dec 13:31:100382.
doi: 10.1016/j.tcr.2020.100382. eCollection 2021 Feb.

Saving the lower limb with GlassBONE™ - Successful surgical revision of pseudarthrosis after infected open proximal tibia fracture type IIIC with bioactive glass grafting - A case report

L Tetzel  1 , M Guyard  2
Affiliations
Case Reports

Saving the lower limb with GlassBONE™ - Successful surgical revision of pseudarthrosis after infected open proximal tibia fracture type IIIC with bioactive glass grafting - A case report

L Tetzel et al. Trauma Case Rep. .

Erratum in

Abstract

Background: The management of bone defect due to trauma or surgical debridement is a current problem in orthopedic trauma surgery, often complicated by infection and bone nonunion. The graft is one of the most challenging variables in surgical treatment. Bioactive Glass (BAG) as a biocompatible and osteogenic product is a promising bone substitute showing good results in maxillo-facial-, spine surgery and treatment of osteomyelitis. Surprisingly, there is very little data on BAG use in trauma surgery.

Case presentation: A 51-year-old male patient, involved in a motorcycle accident, suffered an open proximal tibia fracture, type IIIC, of the left leg. Patient was admitted in January of 2013 to a general orthopedic department for surgical treatment. After several surgical revisions due to infection, vascular damage, and bone nonunion, the patient was successfully treated with Masquelet therapy followed by GlassBONE™ grafting (GlassBONE™ 45S5; Norarker). The patient demonstrated excellent results over the course of a two-year follow-up.

Conclusions: In our experience, GlassBONE™ 45S5 has proven to be an effective bone substitute even in difficult grafting conditions, including multiple surgical revisions for bone nonunion and infection. In our case, at the end of 2 years and 3 months of follow-up, the patient reported no pain, and had no signs of infection. Bone union and full weight bearing was achieved.This case report is oriented by the CARE guidelines for clinical case reports; the patient gave consent for publication.

Keywords: BAG; Bone nonunion; Tibia fracture.

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Figures

Fig. 1
Fig. 1
Clinical aspect and anterior-posterior view (ap view) of leg axis showing varus deformity before Masquelet therapy.
Fig. 2
Fig. 2
ap- and lateral view of left leg before Masquelet therapy.
Fig. 3
Fig. 3
Therapy plan.
Fig. 4
Fig. 4
ap- and lateral view of left knee after cement spacer implantation.
Fig. 5
Fig. 5
ap- and lateral view of left knee after GlassBONE grafting and plate fixation.
Fig. 6
Fig. 6
ap view of left leg at 1 month, 6 months and 24 months postoperatively.
Fig. 7
Fig. 7
Lateral view of leg at 1 month, 6 months and 24 months postoperatively.
Fig. 8
Fig. 8
CT-scan: ap and lateral view of left leg 18 months postoperatively.
Fig. 9
Fig. 9
Clinical aspect and ap view of leg axis 24 months postoperatively.
See this image and copyright information in PMC

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