Artificial Deformity Creation Method for Large (200 cm2) Soft-Tissue Defect in Patient with Infected Tibial Open Fracture

Soft-tissue defect treatment of open fractures or as a result of the infection is always a serious and challenging problem that needs high-qualified medical personal, a lot of time, resources, and patient’s compliance. In some situations, it is not possible to make a defect coverage with a flap (Sen et al., Journal of Orthopaedic Trauma 18:150–157, 2004; Robert Rozbruch et al., J Orthop Trauma 20: 194–202, 2006). Artificial Deformity Creation (ADCr) method, followed by progressive deformity correction and lengthening, is one of the prospective methods used to deal with complex fractures combined with large soft tissue defect. Acute shortening (6 cm), angulation (20°), and rotation (10°) were performed to bring the wound edges closer to a patient with an open infected fracture of the lower leg and a soft tissue defect of 200 cm2. Gradual correction using orthopedic hexapod provided soft tissue growth. To eliminate LLD, osteotomy and distraction osteogenesis were used. An excellent anatomical and functional result was obtained.