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.