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8. Catastrophic osteomyelitis following percutaneous wire fixation of a distal radial fracture: a cautionary tale of poor patient selection followed by surgical mishap.

Author

Shields, David W., Elson, David W., Marsh, Martin, and Gray, Andrew C.

Subjects
OSTEOMYELITIS diagnosis, CONTINUUM of care, DEMENTIA, FRACTURE fixation, BONE fractures, RADIAL bone, RADIUS bone injuries, FOREIGN body reaction, PATIENT selection
Abstract

We present a case of distal radius fracture. Several sequential unfortunate events resulted in a poor outcome. The patient was poorly selected because the degree of early dementia was not fully appreciated, due to intermittent periods of lucidity. Having elected to treat this distal radius fracture with Kirschner wires, a wire snapped during the procedure and was deemed safe to leave within the medullary cavity. Subsequently, the patient was left in a cast for 4 weeks without regular pin site inspection. When the cast was removed a gross osteomyelitis had developed. This series of events, led to unnecessary morbidity and extended the immobilisation time with reduced wrist function. This case highlights the importance of careful patient selection, surgical tactics and continuity of care. [ABSTRACT FROM AUTHOR]

Published
2013
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