Chronic Posttraumatic Tibial Osteomyelitis Treated with Bone Window and Gastrocnemius Flap

Thirty-five years after a motor vehicle accident, a 68-year-old ambulating patient presents with chronic localized osteomyelitis of the right tibia with a draining sinus at the proximal third of the anterior tibia. Via a multidisciplinary approach, a single stage surgery was performed. Extensive debridement of the soft tissue and bone was executed, followed by local delivery of antibiotics through intramedullary placement of antibiotic impregnated calcium sulfate beads. Obliteration of dead space and reconstruction of the soft tissues was accomplished by harvest of a proximally based medial gastrocnemius flap and split thickness skin graft.