“Traumatic fistula of glenohumeral joint with concurrent osteomyelitis and infection of periarticular tissues. The use of negative pressure therapy as one of the elements of treatment of chronic traumatic wound.”

Abstract

A negative pressure dressing system enables effective dressing of traumatic wounds. Extensive injuries and tissue defects that accompany bone fractures and articular surface injuries require special management. In case of compound fractures, the risk of bone, joint and soft tissue infection significantly increases, so the appropriate healing process of traumatic wound is limited.  Undisturbed healing process of traumatic wound is conditioned only by the proper wound dressing process by the removal of necrotic and ischemic tissues and elimination of the sources of infection and infections themselves. The article shows a case report of a patient with a traumatic subcapital humerus fracture complicated by a haematoma and then by a periarticular abscess. After the incision and drainage of a reservoir of blood and pus, a chronic infected fistula of glenohumeral joint was formed. During a prolonged therapeutic process an aggressive surgical management was implemented, by the removal of the infected bone, what eliminated the actively secreting fistula of glenohumeral joint. Following the appropriate wound preparation, the negative pressure therapy was successfully applied.  In the described case the application of negative pressure dressing system enabled a gradual decrease of total wound depth and surface area and consequently, a restriction of tissue defects.