Suneja Nishant, Tischler Eric H, Lockwood Skye, Wolfert Adam J, Martingano Daniel, Praditpan Piyapa, Lyon Thomas
Department of Orthopaedic Surgery, Harvard Medical School, Massachusetts General, 55 Fruit Street, Yawkey 3C, Boston, MA 02114, USA.
Department of Orthopaedic Surgery and Rehabilitation Medicine, State University of New York, Downstate Medical Center, 450 Clarkson Avenue, MSC 30, Brooklyn, NY 11203, USA.
Case Rep Orthop. 2021 May 3;2021:5594270. doi: 10.1155/2021/5594270. eCollection 2021.
Rotational displaced pelvic ring injuries are associated with internal injuries to both the gastrointestinal and genitourinary viscera and anatomic structures. Vaginal lacerations and open genitourinary-associated injuries are at increased risk of mortality due to sepsis. . This case presents a 65-year-old female status post-pedestrian-vehicle struck diagnosed with an open pelvic fracture with extension into the outer one-third of the vaginal wall. The patient was successfully treated with emergent surgical debridement, pelvic stabilization, and internal placement of a novel combination of metronidazole antibiotic gel and vancomycin/tobramycin Polymethyl methacrylate beads.
No evidence of infection was observed with the use of topical metronidazole-coated vancomycin/tobramycin Polymethyl methacrylate beads for contaminated open pelvic fracture injury involving the vaginal wall. Further research on antibiotic gels for use in high-risk open fractures is required.
旋转移位型骨盆环损伤常伴有胃肠道和泌尿生殖内脏及解剖结构的内部损伤。阴道撕裂伤和开放性泌尿生殖系统相关损伤因败血症导致死亡的风险增加。本病例为一名65岁女性，行人被车辆撞击后诊断为开放性骨盆骨折，骨折延伸至阴道壁外三分之一处。患者通过紧急手术清创、骨盆稳定以及甲硝唑抗生素凝胶与万古霉素/妥布霉素聚甲基丙烯酸甲酯珠粒的新型组合内部植入治疗成功。
对于涉及阴道壁的污染开放性骨盆骨折损伤，使用局部甲硝唑涂层的万古霉素/妥布霉素聚甲基丙烯酸甲酯珠粒未观察到感染迹象。需要对用于高危开放性骨折的抗生素凝胶进行进一步研究。
