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Case Reports
. 2024 Jan 24;2024(1):rjae016.
doi: 10.1093/jscr/rjae016. eCollection 2024 Jan.

Lower limb preservation in pediatric trauma: a case study of Gustilo grade IIIC fracture in a 7-year-old

Jamal Ataya  1 , Rawan Daaboul  2 , Hassan Alhomsi  3 , Hassan Issa  4 , Ahmad Elewee  4
Affiliations
Case Reports

Lower limb preservation in pediatric trauma: a case study of Gustilo grade IIIC fracture in a 7-year-old

Jamal Ataya et al. J Surg Case Rep. .

Abstract

This case report describes the intricate aspects of managing pediatric lower limb trauma. A 7-year-old patient had a severe compound fracture and significant soft tissue damage in the left lower limb, classified as Gustilo Grade IIIC. This necessitated the use of scoring systems such as the Mangled Extremity Severity Score and limb salvage index to assess the likelihood of limb preservation. Despite these high amputation risk indicators, a multidisciplinary approach has led to limb salvage surgery with internal fixation. Detailed postoperative monitoring revealed progressive recovery culminating in restored sensation, bone healing, and functional recovery. The discussion emphasizes the difficulties in deciding between limb salvage and amputation, stressing the importance of tailored care and cautious scoring system interpretation in pediatric cases. This conclusion advocates the prioritization of limb salvage in children owing to their unique healing capabilities while highlighting the need for further research to refine treatment protocols for pediatric lower limb trauma.

Keywords: Gustilo grade IIIC; case report; crush injury; internal fixation; limb salvage.

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Conflict of interest statement

None declared.

Figures

Figure 1
Figure 1
Displays the fractured image alongside the X-ray images taken prior to the intervention.
Figure 2
Figure 2
Shows the leg following the placement of the K-wire and prior to suturing the skin flap.
Figure 3
Figure 3
Displays the leg after suturing the skin flap, along with the X-ray image following the installation of the K-wires.
Figure 4
Figure 4
Shows the leg 2 months post-surgery, following the removal of wires.
Figure 5
Figure 5
Shows the leg after 8 months post-surgery, indicating successful completion of the recovery process.
See this image and copyright information in PMC

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