Septic nonunion of the distal tibia in a sickle cell disease patient: a case report

Abstract

Introduction: Septic nonunion of the distal tibia is a challenging complication of open fractures, particularly in sickle cell disease (SCD) patients due to their predisposition to infections and impaired healing. We describe successful management of septic nonunion in an SCD patient. Presentation of case: The patient presented with chronic right leg pain and purulent drainage following an open tibial fracture secondary to a road traffic accident. Open reduction and external fixation failed to achieve union, leading to atrophic nonunion with chronic osteomyelitis. Debridement, fibula corticotomy, proximal tibia osteotomy, and Ilizarov ring fixator placement for bone transport were performed. Bone transport commenced on day 7, with successful docking at 5 months, indicating progression toward union. Discussion: Septic nonunion is a complex condition complicated by chronic infection and impaired bone healing. The Ilizarov technique addresses infection, bone defects, and deformities simultaneously with high union rates. Conclusion: This case underscores the efficacy of the Ilizarov method in managing complex septic nonunion in SCD patients and highlights the need for multidisciplinary care to optimize outcomes.