Lower limb preservation in pediatric trauma: a case study of Gustilo grade IIIC fracture in a 7-year-old

Author:

Ataya Jamal1ORCID,Daaboul Rawan2,Alhomsi Hassan3,Issa Hassan4,Elewee Ahmad4

Affiliation:

1. Faculty of Medicine, University of Aleppo , Aleppo, Syria

2. AlBaath University Faculty of Medicine, , Homs, Syria

3. Faculty of Medicine, Damascus University , Damascus, Syria

4. Department of Orthopedic Surgery , Damascus Hospital, Damascus, Syria

Abstract

Abstract This case report describes the intricate aspects of managing pediatric lower limb trauma. A 7-year-old patient had a severe compound fracture and significant soft tissue damage in the left lower limb, classified as Gustilo Grade IIIC. This necessitated the use of scoring systems such as the Mangled Extremity Severity Score and limb salvage index to assess the likelihood of limb preservation. Despite these high amputation risk indicators, a multidisciplinary approach has led to limb salvage surgery with internal fixation. Detailed postoperative monitoring revealed progressive recovery culminating in restored sensation, bone healing, and functional recovery. The discussion emphasizes the difficulties in deciding between limb salvage and amputation, stressing the importance of tailored care and cautious scoring system interpretation in pediatric cases. This conclusion advocates the prioritization of limb salvage in children owing to their unique healing capabilities while highlighting the need for further research to refine treatment protocols for pediatric lower limb trauma.

Publisher

Oxford University Press (OUP)

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