[Surgical wound dehiscence and exposed hardware. Infection foretold?]

Area of Science:

• Orthopedic Surgery
• Trauma Management

Background:

• Surgical wound dehiscence with exposed internal fixation is a significant orthopedic complication.
• It is a major risk factor for deep bone infection.

Observation:

• An adult patient presented with a 20 cm ulnar plate fully exposed six years post-surgery for a Monteggia fracture-dislocation.
• The patient had a history of drug dependence and no follow-up care.
• Remarkably, there were no signs of infection, and the fracture had healed with misalignment.

Findings:

• The exposed ulnar plate, despite prolonged exposure, did not lead to infection.
• Spontaneous epithelialization occurred over the bone bed after plate removal.
• Complete skin coverage was achieved within two months.

Implications:

• This case demonstrates that bone consolidation is possible even with long-term exposure of internal fixation devices in adults.
• It challenges the assumption that exposed hardware invariably leads to infection in open fractures.
• Highlights the potential for unexpected healing outcomes in complex orthopedic cases.