Abstract:
Background: Tibial diaphyseal fractures often complicate and
result in Acute compartment syndrome. It is associated with significant
morbidity and mortality unless treated promptly. Fasciotomy is one of
the mainstays of treatment, and wound closure can be challenging.
Case Presentation: This case report showcases our experience
with a relatively new and innovative device, the Pasha Device, in dermo
traction to facilitate delayed primary closure of a fasciotomy wound due
to a closed tibial diaphyseal fracture and vascular injury. A
27-year-old male suffered from a road traffic accident and presented
with a closed tibial fracture and compromised distal neurovascular
bundle, prompting an urgent fasciotomy. Following the repair of the
transacted posterior tibial artery and the application of an external
fixator, the Pasha device was employed for wound closure. Based on the
Illizarov method, this device facilitated dermo traction through the
progressive closure of wound edges over 20 days. Informed consent was
obtained from the patient. Complete wound closure was achieved by day
35, demonstrating the effectiveness of dermo traction in promoting
delayed primary closure, especially in situations with vascular
compromise. A satisfactory wound-healing ratio was achieved within this
period, underscoring how this strategy can expedite recovery and reduce
the risk of infection.
Conclusions: The use of the Pasha Device for dermo traction
presents a promising strategy for managing fasciotomy wounds associated
with tibial fractures, especially in cases complicated by vascular
injury. Further study is crucial to validate its efficacy and safety in
a larger cohort. This could potentially offer a cost-effective and
efficient method for wound closure in complex orthopedic cases, and your
contribution to this research is invaluable.