Reconstruction of post-osteomyelitis 1st ray phalangeal loss by reverse dermis cross toe flap and fibula bone grafting: A rare case report |
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| Institution: | 1. OrthoKids Clinic, Ahmedabad, Gujarat, India;2. OrthoKids Clinic, 7th Floor, Golden Icon, Opp. Medilink Hospital, Near Shivranjini Flyover, Satellite, Ahmedabad 380015, India;1. Department of Orthodontics, 251 Air Force General Hospital, Athens, Greece;2. Department of Orthodontics, School of Dentistry, Aristotle University of Thessaloniki, Thessaloniki, Greece;3. Department of Orthodontics and Dentofacial Orthopedics, Dental School, Medical Faculty, University of Bern, Bern, Switzerland; private practice, Corfu, Greece;1. Department of Orthodontics and Craniofacial Biology, Radboud University Medical Center, Nijmegen, The Netherlands;2. Department of Dentistry, Radboud University Medical Center, Nijmegen, The Netherlands;1. Preventive Medicine Department, Alcorcon University Hospital Foundation, Madrid, Spain;2. Preventive Medicine and Public Health and Medical Immunology and Microbiology Department, King Juan Carlos University, Madrid, Spain;3. Paediatric Department, Alcorcón University Hospital Foundation, Madrid, Spain;4. Epidemiology Unit, Regional Ministry of Health, Community of Madrid, Madrid, Spain;1. Division of Orthodontics, College of Dentistry, Ohio State University, Columbus, Ohio;2. College of Arts and Sciences, Department of Psychology, Ohio State University, Columbus, Ohio;3. Advanced Graduate Education Program in Orthodontics, Department of Developmental Biology, Harvard School of Dental Medicine, Boston, Mass;1. Hand Surgery and Limb Reconstructive Surgery Department, La Timone Hospital, 13005 Marseille, France;2. Department of Thoracic Surgery, Lung Transplantation and Diseases of the Esophagus, North University Hospital, 13015 Marseille, France;3. Department of Neurosurgery, La Timone Hospital, 13005 Marseille, France |
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| Abstract: | Osteomyelitis is defined as infection of the bone and its marrow. It is more common in children due to growing bones and rich blood supply. Although long tubular bones are most common to get involved, no bone is exempted from acute hematogenous osteomyelitis and metatarsals account for 2% of all cases of acute hematogenous osteomyelitis. A rare case of Community Aquired-Methicillin Resistant Staphylococcus Aureus (CA-MRSA) osteomyelitis of great toe with complete sequestration of proximal phalanx in an adolescent managed with reverse dermis cross-toe flap and inter-positional fibular grafting is presented. On the basis of our experience with this case, it is also concluded that post infective phalangeal loss with significant soft tissue necrosis does not necessarily entails amputation. With a staged soft tissue coverage and bone loss management, a good clinical, cosmetic and functional outcome can be achieved. |
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| Keywords: | MRSA Phalangeal loss Osteomyelitis MTP Fusion Reconstruction Amputation |
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