[Surgical wound dehiscence and exposed hardware. Infection foretold?]

Abstract

Introduction: surgical wound dehiscence with exposure of internal fixation material is a serious problem in orthopedic surgery and an important factor for infection.

Objective: presentation of an unusual case of an adult patient with surgical wound dehiscence and complete exposure of 20 cm of the ulnar plate after six years of surgery, without infection signs, with bone healing and skin behind the plate.

Case presentation: 39-year-old man with an open Gustilo II Monteggia fracture-dislocation multifracture. The patient had a history of drug dependence. He had an open reduction and internal fixation with an ulnar reconstruction plate. The patient did not have any follow-up. After six years of the surgery, there was a complete exposure of the plate (20 cm) without infection and healing of the fracture with misalignment. After removing the plate, we observed spontaneous epithelialization attached to the bone bed. Skin coverage was complete at two months.

Conclusion: although unusual, bone consolidation without infection is possible in an open fracture with long-standing exposure to a forearm plate in the adult.