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Updated: Jun 26, 2026
Pseudofracture: An Acute Peripheral Tissue Trauma Model
Published on: April 18, 2011
Necrotizing fasciitis-A catastrophic complication following routine tibia fracture surgery: A case report and
Shuai Shang1, Ruipeng Zhang, Zhiyong Hou
1Department of Orthopaedic Surgery, Third Hospital of Hebei Medical University, Shijiazhuang, Hebei, China.
Rationale:
Necrotizing fasciitis (NF) is defined as a rare, life-threatening, rapidly spreading soft tissue infection resulting from a polymicrobial origin, with a predominance of anaerobic organisms that presents with necrosis of the muscle, fascia, and surrounding soft tissue.
Patient Concerns And Diagnoses:
A 64-year-old male who sustained tibia fracture caused by falling from a height underwent a tibia surgery with minimally invasive plate osteosynthesis technique in another institution. Postoperatively, the patient had development of a very uncommon NF at the site of the tibia procedure. When the patient was transferred to our unit, he rapidly processed to toxic shock and coagulopathy.
Interventions And Outcomes:
Although the patient underwent antibiotics treatment in the emergency room and was transferred to the operating room for surgery promptly, the patient's condition deteriorated rapidly and he died of septic shock and multiple organ failure unfortunately.
Lessons:
Our study aims to highlight the risk of NF in the elderly with diabetes during the perioperative period even if the injury is a simple closed fracture. Physicians must be vigilant to early inflammatory signs and pain in immunosuppressed patients.
Insights
Elderly patients with diabetes are at risk for necrotizing fasciitis (NF) after surgery, even for simple fractures. Early recognition of inflammatory signs is crucial for prompt intervention in these vulnerable individuals.
Area of Science:
- Infectious Diseases
- Surgical Complications
- Geriatric Medicine
Background:
- Necrotizing fasciitis (NF) is a severe, rapidly progressing soft tissue infection.
- It is characterized by polymicrobial involvement, often with anaerobic bacteria.
- NF leads to necrosis of muscle, fascia, and surrounding tissues, posing a life-threatening risk.
Observation:
- A 64-year-old male with a tibia fracture underwent minimally invasive plate osteosynthesis.
- Postoperatively, the patient developed necrotizing fasciitis at the surgical site.
- Upon transfer, he rapidly progressed to toxic shock and coagulopathy.
Findings:
- Despite prompt antibiotic treatment and surgical intervention, the patient's condition worsened.
- The patient ultimately succumbed to septic shock and multiple organ failure.
- This case highlights an uncommon but severe complication following orthopedic surgery.
Implications:
- Elderly patients, particularly those with diabetes, face increased perioperative risk for NF.
- Vigilance for early inflammatory signs and pain is essential in immunosuppressed patients.
- This case underscores the importance of heightened awareness for NF in specific patient populations.
