A 70-year-old male patient suffered an open infrasindesmotic fibular fracture (Gustilo grade II), which was treated urgently by reduction and internal fixation.
The patient was admitted with chronic osteomyelitis caused by Baoides vulgatus and skin lesion with loss of 8 cm in diameter.
Surgical intervention was performed, removing the material from oteosyntesis and debridement of the focus of osteomyelitis.
After this, exposure of bone tissue and posterior tibial tendon was observed, with intra-articular communication.
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It was decided to combine intravenous antibiotic treatment and vacuum therapy Renasys® to -125 mm Hg and microbiological monitoring of the lesion to propose surgical coverage.
The evolution of the lesion with vacuum therapy is satisfactory, maintaining negative wound cultures, so that in 4 weeks the defect is closed, requiring only coverage, under local anesthesia, by means of skin graft.
After the first cure performed 4 days after the intervention, the graft was completely stuck and the patient was discharged.
