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锁定钢板外固定联合负压伤口治疗闭合性锁骨骨折原发性感染

Locking plate external fixation and negative pressure wound therapy for treatment of a primary infection in a closed clavicle fracture.

作者信息

Kenyon Robert M, Morrissey David I, Molony Diarmuid C, Quinlan John Francis

机构信息

Adelaide and Meath Hospital, Dublin, Ireland.

Department of Trauma and Orthopaedics, The Adelaide and Meath Hospital Incorporating the National Childrens Hospital, Dublin, Ireland.

出版信息

BMJ Case Rep. 2016 Nov 28;2016:bcr2016218241. doi: 10.1136/bcr-2016-218241.

Abstract

Infection in a clavicle fracture is uncommon, but remains a challenging problem. A paucity of soft tissue coverage often combined with significant displacement and interfragmentary movement add complexity to an already difficult situation for effective infection treatment. External fixation in principle offers a means of achieving fracture stability, while the infection is being eradicated. We present the case of a closed clavicle fracture, initially treated conservatively, that presented 5 weeks later with infection. The fracture was definitively treated with external fixation using a locking plate positioned superficially to the skin, plus negative pressure wound therapy and subsequent secondary closure and antibiotic therapy. This case illustrates a novel method of treatment in this unusual presentation that was well tolerated by the patient and resulted in a good clinical outcome.

摘要

锁骨骨折感染并不常见,但仍然是一个具有挑战性的问题。软组织覆盖不足,常伴有明显移位和骨折块间活动,这给本来就困难的有效感染治疗局面增添了复杂性。原则上,外固定提供了一种在根除感染的同时实现骨折稳定的方法。我们报告一例闭合性锁骨骨折病例,最初采用保守治疗,5周后出现感染。骨折最终采用外固定治疗,使用一块置于皮肤表面的锁定钢板,同时进行负压伤口治疗,随后进行二期缝合和抗生素治疗。该病例说明了这种不寻常表现的一种新的治疗方法,患者耐受性良好,临床效果良好。

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本文引用的文献

4
External fixators in the treatment of midshaft clavicle non-unions: a systematic review.外固定器治疗锁骨中段骨不连:一项系统综述
Eur J Orthop Surg Traumatol. 2014 Feb;24(2):143-8. doi: 10.1007/s00590-013-1173-6. Epub 2013 Feb 20.
6
Bilateral clavicle fracture external fixation.双侧锁骨骨折外固定。
Orthop Traumatol Surg Res. 2010 Nov;96(7):821-4. doi: 10.1016/j.otsr.2010.02.017. Epub 2010 Sep 17.
9
Infection after clavicle fractures.锁骨骨折后感染。
Clin Orthop Relat Res. 2005 Oct;439:74-8. doi: 10.1097/01.blo.0000183088.60639.05.

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