A case report on the successful treatment of a specific type of open ankle fracture-dislocation called logsplitter injury.

Abstract

This case report presents the successful management of a rare and complex open ankle fracture-dislocation known as a 'Logsplitter Injury', resulting from a high-energy traumatic event. The patient, a Chinese male in his early 20 s, sustained a severe left lower limb injury in a traffic accident. Initial clinical assessments revealed significant swelling, pain and an open fracture with extensive soft tissue damage. The patient underwent an emergency surgical intervention, involving meticulous wound debridement, internal fixation and reconstruction of the lower tibiofibular union, was performed. The use of vancomycin-loaded polymethylmethacrylate bone cement and negative pressure wound therapy contributed to the favourable outcome. Post-operative care encompassed comprehensive analgesia and infection prevention measures, resulting in substantial ankle function recovery. Follow-up assessments revealed healed fractures and excellent joint alignment, with the patient attaining an AOFAS score of 85, indicative of good functional recovery. This case underscores the effectiveness of individualised treatment plans and multidisciplinary teamwork in managing such challenging injuries, offering valuable clinical insights and highlighting the potential for successful outcomes with timely and precise surgical interventions.