Type I, II Acute Necrotizing Fasciitis of the Low Extremity / 대한정형외과학회잡지

ABSTRACT

PURPOSE: To retrospectively analyze the clinical presentations, radiographic findings, and surgical results of type I and II acute necrotizing fasciitis of the low extremity. MATERIALS AND METHODS: From April 1998 to March 2005, 13 patients who underwent surgery for the necrotizing fasciitis were reviewed. At the initial diagnosis, 6 patients were diagnosed with cellulitis and 3 patients were diagnosed correctly with necrotizing fasciitis. The underlying diseases, affected sites, official readings of MRI, the intervals between the onset of symptom and surgery, the duration of admission, and complications were investigated. RESULTS: The underlying diseases were 3 cases of diabetes, 3 cases of liver disease, 1 case of alcoholism and 1 case of cervical cancer with chemotherapy. Regarding the location of the disease, 5 cases were observed below the knees, and 8 cases were observed above the knees. Five out of 9 cases who underwent a preoperative MRI study, were diagnosed correctly as necrotizing fasciitis by the radiologist. The average period between onset of symptoms and surgery was 4.8 days. The complications were hip disarticulation in 1 case, below knee amputation in 1 case, toe amputation in 1 case, and a limited range of motion of the knee joint in 1 case. The 9 patients who healed without complications had no limitation in the range of joint motion and daily activity. CONCLUSION: Type I and II acute necrotizing fasciitis of the low extremity shows variable clinical presentations and radiological findings. Therefore, the possibility of the necrotizing fasciitis needs to be considered when dealing with patients with soft tissue infections in the low extremities.