PMC9536215_01
Radiograph of the patient at referral showing osteolytic areas surrounding fixation devices, bone sequestrum and translucent zones consequently to purulent exudate collection, lack of bone callus and obvious fracture line (arrows).
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Richter Pharma, Austria) at a dose of 7.5 mg/kg, applied intramuscularly in m. quadriceps femoris, mediolateral and craniocaudal radiographs were performed with a stationary X-ray unit (Philips, Bucky Diagnost CS4, Holland) and iQ-CR ACE digital station with iQ-VIEW/PRO v. 2.7 software. Radiographs showed osteolytic areas around fixation elements, a bone sequestrum and translucent zones due to pus collection, lack of bone callus and an obvious fracture line (Figure 1).
Modified external fixator made of two silicone tube bars filled with Duracryl Plus (rapidly self-curing metacrylate polymer) and 6 Kirschner wires. The arrow points at the autograft.
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Fixation wires passed percutaneously and perpendicularly through both bone cortices (3 in the proximal radius with diameter 1.6 mm, one in cortical graft with diameter 1.2 mm, one 1.6-mm wire in the distal radius and another one, also with diameter 1.6 mm - in metacarpal bones) (Figure 2).
Mediolateral (left) and craniocaudal (right) radiographs of operated limb by the 13th post operative week demonstrating cortical graft bridging (arrows).
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Control radiography (Figure 3) demonstrated a very good bridging of the cortical graft without loosening of fixation elements.
Mediolateral (left) and craniocaudal (right) radiographs after removal of the external fixator. Arrows show bone callus remodelling proximally and distally to the cortical autograft.
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After removal of the external fixator, complete bone healing and bone callus remodelling proximally and distally to the cortical autograft were demonstrated (Figure 4).