Chronic Implant-Associated Osteomyelitis of the Distal Humerus: A Case Report of Latissimus Dorsi Pedicled Flap Reconstruction

A man in his 20s developed chronic osteomyelitis following surgical fixation of a compound distal humerus fracture. He presented with pain, discharging sinuses from the operated site, and restricted elbow movement. A staged limb salvage strategy was employed. The first stage involved implant removal, extensive bone and soft tissue debridement with antibiotic cement bead placement, and primary skin closure. Post-surgery, he developed wound dehiscence and infection, not treated by antibiotic therapy. A secondary wound debridement along with negative pressure therapy was done. Three weeks later, once the infection was controlled, reconstruction using a pedicled latissimus dorsi musculocutaneous flap with definitive bony fixation was done. At one-year follow-up, the patient demonstrated satisfactory wound healing, no recurrent infection, and meaningful improvement in pain and function. This case underscores the value of staged, multidisciplinary management in complex post-traumatic elbow infections and establishes the pedicled latissimus dorsi flap as a reliable reconstructive option.