Resolving a case with septic complication after total knee prothesasion at an oncological patient

Abstract

Introduction: The first data about the importance of the vascularization of bone graft transplant appear in 1905 (Huntington T.W.) As the authors mentioned, this helps callus formation in ordinary terms. In 1975 found the first data about successful transfer human vascularized fibula (Taylor G.I.) two years later, the same authors describe the first migration of the proximal fibula, for the replacement of the distal femoral defect. The purpose of the work: Presenting a solved case of bone defect, that occurred after ablation of the total knee prosthesis complicated septic in an oncology patient. Materials and Methods: This work presents the clinical case of a woman of 30 years, who was diagnosed in 2009 with osteoclastoma in1/3of the distal femur operated in the same year in the Oncology Institute, was removed the tumor and was done total knee joint prothesation, at the end of 2015 at our clinic addressed with an septic area at pelvic right limb. After performing preoperative planning, I decided to solve in 2 surgery stage. At the first stage we performed ablation of the protthesis. In another step we made the right knee joint arthrodesis with a vascularized fibular flap. Bone transplantation with a length of 20 cm with a pedicle of 10 cm that was migrated through rollover technic, that in his structure enetered a muscular sleeve and skin island for future monitoring. At the final, the leg was stabilized in an external extrafocar device. After 4 months later, at a follow-up visit, the patient moves independently, using crutches and moderate support on the foot. Conclusions: Using a composite musculoskeletal cutaneous vascular defect axially allow reconstruction complicated septic at pelvic limb without following the required period.