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采用负压封闭引流、TopClosure装置及Ilizarov技术联合治疗创伤性半侧骨盆切除术:成功修复大面积软组织缺损的罕见病例报告

Combined treatment with vacuum sealing drainage, TopClosure device, and Ilizarov technique for traumatic hemipelvectomy: A rare case report of successful repairing of large-size soft tissue defects.

作者信息

Li Jin, Shi Jie Bao, Hong Pan, Wang Yu Shang, Ze Hao Ren, Lee Rushyuan Jay, Tang Xin

机构信息

Department of Orthopaedic Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China.

Department of Orthopaedic Surgery, Bloomberg Children's Hospital, Johns Hopkins Hospital, Baltimore, MD, United States.

出版信息

Medicine (Baltimore). 2019 Jan;98(4):e14205. doi: 10.1097/MD.0000000000014205.

Abstract

RATIONALE

Traumatic hemipelvectomy is a rare but lethal catastrophic injury.

PATIENT CONCERNS

A case of a very young child with open fracture of left sacroiliac joint dislocation and pubic symphysis diastasis, suffered from a severe large-size soft tissue defects.

DIAGNOSIS

Traumatic hemipelvectomy.

INTERVENTIONS

Complete amputation was performed and three kinds of surgical techniques including regulated negative pressure-assisted wound therapy (RNPT), TopClosure device, and Ilizarov technique were jointly utilized to secure closure in the further revisions of the soft tissue injury and reconstruct reconstructive surgery.

OUTCOMES

Six months after hospital discharge, the patient was able to ambulate with a single limb and a prosthesis and she is independent in many activities of daily living currently.

LESSONS

We report this case to share experience with other clinicians in the management of this deadly extensive defects after traumatic hemipelvectomy in patients.

摘要

理论依据

创伤性半侧骨盆切除术是一种罕见但致命的灾难性损伤。

患者情况

一名非常年幼的儿童,左侧骶髂关节脱位和耻骨联合分离开放性骨折,伴有严重的大面积软组织缺损。

诊断

创伤性半侧骨盆切除术。

干预措施

进行了完全截肢,并联合应用了三种手术技术,包括规范化负压辅助伤口治疗(RNPT)、TopClosure装置和伊里扎洛夫技术,以确保在软组织损伤的进一步修复和重建手术中实现伤口闭合。

结果

出院6个月后,患者能够单肢佩戴假肢行走,目前在许多日常生活活动中能够自理。

经验教训

我们报告此病例,以便与其他临床医生分享创伤性半侧骨盆切除术后患者这种致命性广泛缺损的处理经验。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/85d1/6358379/de2a16184a0e/medi-98-e14205-g001.jpg

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