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Review
. 2025 Mar;20(2):NP13-NP19.
doi: 10.1177/15589447241259799. Epub 2024 Jun 13.

Necrotizing Soft Tissue Infection Following a Closed Distal Radius Fracture: A Case Report and Literature Review

Jenaleen Law  1 , Liron S Duraku  1   2 , Brahman Sivakumar  1 , Mark Hile  1
Affiliations
Review

Necrotizing Soft Tissue Infection Following a Closed Distal Radius Fracture: A Case Report and Literature Review

Jenaleen Law et al. Hand (N Y). 2025 Mar.

Abstract

Necrotizing soft tissue infections (NSTIs), characterized by extensive soft tissue destruction, are rare but life-threatening. We present a case of a NSTI in a healthy 65-year-old woman following a closed distal radius fracture. The patient presented with severe pain, fever, and lethargy 4 days after her index injury, with physical examination of the right upper limb revealing erythema and swelling to the mid-humeral level and blisters of the fingers and hand. Multiple surgical debridements were required to control the infection, which was caused by Streptococcus pyogenes. This case highlights the rapid progression and devastating consequences of NSTI, which can occur even in the setting of closed injuries in patients without comorbidities. Prompt diagnosis, early surgical intervention, and appropriate antimicrobial therapy are crucial in managing this pathology.Level of Evidence: Level 5.

Keywords: Colles fracture; Streptococcus pyogenes; closed fracture; distal radius fracture; necrotizing soft tissue infection.

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Conflict of interest statement

Statement of Human and Animal RightsThere are no conflicts regarding human and animal rights with respect to this manuscript. Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Figures

Figure 1.
Figure 1.
Radiograph of the right distal radius fracture.
Figure 2.
Figure 2.
Right upper limb on presentation to our unit, 4 days after the closed distal radius fracture.
Figure 3.
Figure 3.
Right upper limb wound after 5 surgical debridements.
Figure 4.
Figure 4.
Reconstructed right upper limb using dermal matrix and split-thickness skin grafts at 2 months after index injury.
Figure 5.
Figure 5.
Reconstructed right upper limb at the 10-month follow-up.
See this image and copyright information in PMC

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