[手术伤口裂开和暴露的硬件。是否预示着感染?]

Acta ortopedica mexicana Pub Date : 2022-11-01
L Moril-Peñalver, A Sevilla-Monllor, E Saura-Sánchez, C Verdú-Aznar, A Lizaur-Utrilla, F López-Prats
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引用次数: 0

摘要

简介:暴露于内固定材料的手术伤口裂开是骨科手术中的一个严重问题,也是感染的重要因素。目的:介绍一例不寻常的成年患者,在六年的手术后,手术伤口裂开,尺骨板完全暴露在20厘米外,没有感染迹象,骨愈合,板后皮肤。病例介绍:39岁男性,开放性Gustilo II型Monteggia骨折脱位多发性骨折。病人有药物依赖史。他进行了切开复位,并用尺骨重建钢板内固定。该患者没有进行任何随访。经过六年的手术,钢板完全暴露(20厘米),没有感染,骨折错位愈合。取出钢板后,我们观察到附着在骨床上的自发上皮化。两个月时完成皮肤覆盖。结论:尽管不常见,但在长期暴露于前臂钢板的成人开放性骨折中,无感染的骨巩固是可能的。
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[Surgical wound dehiscence and exposed hardware. Infection foretold?]

Introduction: surgical wound dehiscence with exposure of internal fixation material is a serious problem in orthopedic surgery and an important factor for infection.

Objective: presentation of an unusual case of an adult patient with surgical wound dehiscence and complete exposure of 20 cm of the ulnar plate after six years of surgery, without infection signs, with bone healing and skin behind the plate.

Case presentation: 39-year-old man with an open Gustilo II Monteggia fracture-dislocation multifracture. The patient had a history of drug dependence. He had an open reduction and internal fixation with an ulnar reconstruction plate. The patient did not have any follow-up. After six years of the surgery, there was a complete exposure of the plate (20 cm) without infection and healing of the fracture with misalignment. After removing the plate, we observed spontaneous epithelialization attached to the bone bed. Skin coverage was complete at two months.

Conclusion: although unusual, bone consolidation without infection is possible in an open fracture with long-standing exposure to a forearm plate in the adult.

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