Necrotising fasciitis following a supracondylar fracture & o
This case report published in the South African Orthopaedic Journal highlights the association of necrotising fasciitis in a child with an open distal radius fracture and a supracondylar fracture.

A 10-year-old boy was admitted 24 hours after falling from a tree with a Gustilo and Anderson grade II distal radius fracture and a Gartland grade III supracondylar humerus fracture. The wound was debrided and the fractures reduced and stabilised with Kirschner wires.

Within 48 hours of admission he developed a necrotising fasciitis that extended onto the chest and eventually resulted in a shoulder disarticulation. The tissue defects were covered with flaps and skin grafts and the patient was discharged home.

Learning points:-
• This case highlights the importance of having an early and high index of suspicion for necrotising fasciitis in a child with an open contaminated fracture and delay to both antibacterial chemotherapy and surgical debridement.

• Tissue trauma due to open fractures may obscure the early skin signs of necrotising fasciitis as well as laboratory risk factors

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