Clostridial gas gangrene complicating Colles' fracture.

We present a case of Clostridial gas gangrene following closed reduction of a Colles' fracture. A review of the laboratory and clinical literature on treatment of gas gangrene revealed wide differences of opinion regarding the effectiveness of surgery, antibiotics, antitoxin and especially hyperbaric oxygen. We found no previous report of clostridial gas gangrene in closed reduction of a Colles' fracture. The survival rates for 28 cases of Clostridial myonecrosis treated at Vancouver General Hospital with surgery, antibiotics and hyperbaric oxygen were 100% for extremity gangrene and 65% for trunk gangrene. We conclude: Gas gangrene is rare, but can complicate even minor trauma or procedures performed in hospital. Prevention depends on proper debridement of wounds and open fractures. Compartment syndromes may be important as etiologic and complicating factors. Hyperbaric oxygen may have therapeutic value but its use has not improved on survival rates achieved during World War II with surgery and antibiotics alone.