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Open fracture of lower extremity

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A 58- year old male patient presented, after a workplace accident with a 1 tonne of a metal plate on the right lower leg and foot, an open midfoot fracture and big soft tissue defect (Gustilo Anderson grade IIIA). Because of the soft tissue situation an external fixator was used for initial treatment. During hospitalization, progressing skin necrosing areas were presented, with the result that surgical depridements and a VAC (Vacuum Assisted Closure) system was necessary to treat the soft tissue damage.
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