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CASE REPORT
Year : 2018  |  Volume : 6  |  Issue : 1  |  Page : 38-42

Atypical necrotizing fasciitis following surgical treatment for closed ankle fracture dislocation


1 Orthopaedics and Traumatology Department, Curry Cabral Hospital – Central Lisbon Hospital Centre, Lisbon, Portugal
2 Plastic and Reconstructive Surgery Department, São José Hospital – Central Lisbon Hospital Centre, Lisbon, Portugal

Correspondence Address:
Dr. André Grenho
Orthopaedics and Traumatology Department, Curry Cabral Hospital – Central Lisbon Hospital Centre, 8 Beneficência Street, 1050-099 Lisbon
Portugal
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/joas.joas_40_17

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We report the case of a 66-year-old female who sustained a closed ankle fracture dislocation of her right ankle(Weber B; AO 44-B3.2). She underwent an open reduction with internal fixation, complicated with a small, superficial wound dehiscence during the initial follow-up. One month after surgery, she developed inflammatory signs on her right ankle, but disregarded them. One week later, she was admitted into the emergency department with infection of her ankle's osteosynthesis, and a necrotizing fasciitis of her left upper limb, neck, and thorax. The patient underwent multiple surgical interventions for the removal of osteosynthesis hardware, fasciotomies, consecutive debridements, and finally a below-the-knee amputation. Streptococcus pyogenes was identified in several cultures as the responsible agent, and directed antibiotic treatment was performed. However, despite all treatments, the patient's clinical status progressively worsened until she eventually deceased, 1month after admission.


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