Reconstruction of a devastating electric injury: case-report

Area of Science:

• Orthopaedic Surgery
• Reconstructive Surgery
• Trauma Management

Background:

• Electrical injuries can cause devastating soft tissue and bone damage.
• Severe limb trauma requires complex, multi-stage surgical intervention.
• Optimal management of extensive electrical burns remains a challenge.

Observation:

• A 26-year-old patient sustained extensive electrical injuries (13% TBSA) to the chest, right arm, left elbow, and shoulder.
• Surgical intervention involved fascial excision, proximal humerus amputation with scapular fixation, and soft tissue reconstruction.
• The large defect was addressed using a latissimus dorsi myocutaneous flap and a tube pedicle flap.

Findings:

• Successful limb salvage and reconstruction were achieved through a combined orthopaedic and reconstructive surgical approach.
• The use of cerclage fixation to the scapula provided stable proximal humerus stump coverage.
• Flap coverage with latissimus dorsi and tube pedicle flaps effectively managed the extensive soft tissue defects.

Implications:

• This case highlights the feasibility of limb salvage in severe electrical injuries with extensive tissue loss.
• The described reconstructive techniques offer a viable strategy for managing complex upper extremity trauma.
• Multidisciplinary surgical planning is crucial for optimizing outcomes in high-energy trauma cases.