Tibial Plafond Fracture Healing in Coral Reef Aorta - A Case Report
Mariangela Di Già1, Alfredo Trombetta1, Giuliana Roselli2
1Department of Traumatology and General Orthopedics, Careggi University Hospital, Florence, 50100, Italy.
Insights
This case report details the successful management of a leg fracture in a patient with Coral Reef Aorta (CRA), a rare vascular condition. The study highlights effective fracture healing and functional recovery using minimally invasive techniques.
Area of Science:
- Vascular Surgery
- Orthopedic Surgery
- Radiology
Background:
- Coral Reef Aorta (CRA) is an extremely rare calcifying stenosis of the distal aorta.
- CRA can lead to hypoperfusion and thromboembolic events in internal organs and lower limbs.
- Literature primarily consists of case reports, with limited information on fracture management.
Observation:
- A 58-year-old woman with a history of alcohol abuse presented with an open leg fracture after a fall.
- An incidental finding of CRA was noted during abdominal CT scan.
- The patient had a Gustilo I open fracture, treated initially with damage control orthopedics.
Findings:
- Hybrid external fixation was selected as the definitive treatment for the leg fracture.
- The patient achieved complete bone healing and good functional recovery 4 months post-surgery.
- Minimally invasive techniques, including external fixation, are crucial for complex fractures with vascular compromise.
Implications:
- This report is the first to describe fracture management and healing in patients with Coral Reef Aorta.
- Minimally invasive approaches with early mobilization can lead to successful outcomes in complex fractures.
- External fixation and percutaneous techniques should be considered for complex articular fractures involving vascular compromise.
Introduction:
Coral reef aorta (CRA) is a calcifying stenotic disease of the distal aorta that can result in hypoperfusion and thromboembolic episodes of both internal organs and lower limbs. Only case reports of this extremely rare condition are described in the literature. Our report is the first article about fracture management and healing in this anomaly.
Case Report:
A 58-year-old woman with an alcohol abuse story presented to our emergency department after a fall from height. She reported a 43-C3 Gustilo I open leg fracture treated in an emergency with a damage control orthopedic approach. As an incidental finding, a CRA anomaly was found during an abdomen computer tomography scan. Considering the fracture pattern and the patient factors, hybrid external fixation was chosen as the definitive treatment. Complete bone healing and a good functional recovery 4 months after surgery were assessed.
Conclusion:
External fixation and percutaneous techniques must be considered in complex articular fractures with vascular compromise. A minimally invasive approach with early motion and weight bearing allowed for a complete fracture healing without deficits or additional soft tissue damage.
