Thursday, 18 April 2013

2 month old infected supra-intercondylar fracture in a 62 year old diabetic



 

 Infected, with multiple organisms, initially with gut organisms like klebsiella, providentia , E coli etc. Antibiotic treatment ended with pseudomembraneous colitis. They debrided him twice in the OR. The last organism was pseudomonas which was sensitive only to colistin, which he received. Discharging sinus still present
 
 What next
.1 Illizarow in capable hands
2. one final debridement with local stimulan beads with colistin and other "necessary" antibiotics with autologous bone graft  provided the fracture is stable.
any other suggestions welcome

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