Jain Mohit J, Mavani Kinjal
Department of Orthopaedics, V. S. Hospital, and N. H. L. Medical College, Ahmedabad, India.
J Orthop Case Rep. 2016 Nov-Dec;6(5):73-75. doi: 10.13107/jocr.2250-0685.640.
Plasters have been frequently associated with known complications such as infection, and compartment syndrome or deep vein thrombosis. However, life-threatening complication of necrotizing fasciitis (NF) has not been frequently attributed to plaster.
We had a case of a 62-year male developing a lethal NF triggered by a below knee plaster for undisplaced fracture medial malleolus after twisting injury. He had no history suggestive of diabetes, renal impairment, and predisposing allergic factors or any comorbidity. Despite early diagnosis and aggressive management with above knee amputation, death occurs due to septic shock on the 20 day. A similar case of reported lethal NF triggered by plaster has also been reviewed in this report.
This case highlights a life-threatening rare complication of plaster and author recommends thorough clinical history taking, precleaning of limb, use of sterile water and use of adequate wrap around skin for gypsum plasters as prevention apart from high index of suspicion for early diagnosis, and rapid management.
石膏固定常与感染、骨筋膜室综合征或深静脉血栓形成等已知并发症相关。然而，坏死性筋膜炎（NF）这种危及生命的并发症并不常被认为是由石膏固定引起的。
我们有一例62岁男性患者，因扭伤后内踝无移位骨折行膝下石膏固定，引发了致命性坏死性筋膜炎。他没有糖尿病、肾功能损害、易患过敏因素或任何合并症的病史。尽管早期诊断并采取了大腿截肢等积极治疗措施，但患者在第20天因感染性休克死亡。本报告还回顾了一例类似的由石膏固定引发致命性坏死性筋膜炎的病例。
该病例突出了石膏固定一种危及生命的罕见并发症，作者建议除了高度怀疑以便早期诊断和快速治疗外，预防措施还包括详细询问临床病史、肢体预清洁、使用无菌水以及在使用石膏时对皮肤进行充分包裹。
