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Triple Osteosynthesis Technique for Implant-Associated Infection with Nonunion in a Pediatric Open Ulna Fracture: A
Akshaj Sharma1, Sandeep Patil, Sujit N Korday
1Department of Orthopaedics, V. N. Desai Municipal General Hospital, Mumbai, Maharashtra, India.
Case:
A 14-year-old boy with a closed radius and grade 2 open ulna fracture, plus ulnar nerve deficit, developed secondary osteomyelitis after initial plating. Our staged management involved segmental resection with external fixation, followed by fibular strut graft stabilized with flexible nailing and neutralization plate (triple osteosynthesis).
Conclusion:
In literature, seldom has a triple construct been used for such nonunions arising from osteomyelitis. The few existing instances mention using bone graft with either only intramedullary nail or only plate and screws, while we used all 3. The patient showed complete graft incorporation without infection recurrence and achieved full functional recovery.
