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In some trauma cases, the knee joint may become unsalvageable. Instead of an amputation, a knee fusion may be in order. Below we examine a trauma case where a knee fusion was deemed necessary
After experiencing severe trauma to his left leg, this young patient was given a knee replacement which failed.
Doctors then performed a temporary knee fusion which became infected and the patient was in danger of losing his leg.
The infection spread throughout the bones and resulted in a 16cm space where the knee, parts of the tibia, and parts of the femur had to be removed.
This patient was out of options and amputation of the limb seemed imminent. However, he wanted to keep his leg and not settle.
Dr. Fragomen's Plan
The patient came to our center in the hopes of saving their leg. Nothing had worked thus far and the road to recovery was not going to be easy.
After much thought, the plan was to transport a part of the femur down towards the tibia to fill in the gap in the leg. The knee would then be fused.
In order to achieve these goals, the old hardware was removed, the infection was cleaned out, and a femoral osteotomy was performed.
A nail was inserted from the femoral head to the tibia to provide stability, while the external fixator was used to transport the the rest of the femur and fill in the gap.
As the femur was transported to meet the tibia, new bone began to grow in it's place.
The tibia and femur, as well as the femur itself consolidated to form a strong bond.
A plate was added near at the knee and the nail was kept in place for added stability.
The patient is infection free, walking with no restrictions and has no pain.
Dr. Fragomen and his patient after
a successful recovery
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