A collection of complex joint preservation and replacement case studies and random thoughts of a orthopedic surgeon essentially aimed at knowledge dissemination.
Saturday 4 September 2021
2 MONTH OLD DISLOCATED KNEE WITH CELLULITIS IN THE SHIN
fell 2 months after TKR and dislocated the knee. pt (BmI 35) with recurrant cellulitis on the ipsilateral tibial shin shin which is asymptomatic. esr was 110 with a crp of 20. Repeated knee aspiration was negative. incidently a gram negative UTI and large supraclavicular LN was found on admission
planned for a supraclavicular biopsy, frozen section , HPE, cultures and Rotating hinge knee with arthrodesis back up.
frozen section as per fieldmans criterioa showed too many PMNL in more than 5 power field, A modular titanium fusion nail and stimulan with antibiotic polymyxcin and vancomycin was inserted . Pt made to wt bear the same day evening and mobilised
b haemolytic strep grew for which minimum 4 weeeks IV antibiotics is planned.