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骨盆环损伤使用INFIX后的感染

Infection after the use of INFIX in Pelvic Ring Injuries.

作者信息

Vaidya Rahul, Amar Karun, Woodbury Derrek, Washington Austen

机构信息

Detroit Medical Center, 5th Floor Heart Hospital, 311 Mack Avenue, Detroit, Michigan 48201, USA.

出版信息

SICOT J. 2021;7:46. doi: 10.1051/sicotj/2021047. Epub 2021 Sep 8.

Abstract

INTRODUCTION

The purpose of this study is to report on infection with anterior subcutaneous internal pelvic fixation (INFIX) for pelvic ring injuries and the outcomes of treatment.

METHODS

An IRB-approved retrospective study was performed using trauma databases of a level one and level two trauma center from 2012-2018. Infection after the INFIX procedure was diagnosed in 10 of 179 cases. Treatment included formal irrigation and debridement, removal of the hardware, and culture-specific antibiotics. Patients were followed for a minimum of 12 months. Recorded outcomes include X-rays, Majeed scores, and the presence of any loss of reduction using reduction parameters.

RESULTS

Time to detect the infection was 54.2 ± 24.3 days (range 24-90, median 56 days). Staphylococcus aureus was the most common bacteria isolated. The average follow-up was 830 ± 170 days (range 575-1088 days). All patients went on to the radiographic union. There were no recurrent infections or osteomyelitis at the latest follow-up. Patients maintained their reduction after INFIX removal (KI), and Majeed scores ranged from 72 to 96 (seven good, three excellent).

DISCUSSION

Infections after using the INFIX procedure were dealt with by irrigating and debriding the wounds, removing the INFIX with culture-specific antibiotics for 2-6 weeks. Implants were maintained for at least 25 days, and there was no loss of reduction. There were no long-term sequelae noted in this small series or the literature review included in this paper.

摘要

引言

本研究旨在报告骨盆环损伤前路皮下内固定术(INFIX)的感染情况及治疗结果。

方法

使用一级和二级创伤中心2012 - 2018年的创伤数据库进行一项经机构审查委员会批准的回顾性研究。179例患者中,10例在INFIX手术后被诊断出感染。治疗包括正规的冲洗和清创、取出内固定装置以及使用针对性培养的抗生素。对患者进行至少12个月的随访。记录的结果包括X线片、马吉德评分以及使用复位参数评估的复位丢失情况。

结果

感染的发现时间为54.2±24.3天(范围24 - 90天,中位数56天)。金黄色葡萄球菌是最常见的分离出的细菌。平均随访时间为830±170天(范围575 - 1088天)。所有患者均实现影像学愈合。在最近一次随访时无复发性感染或骨髓炎。取出INFIX后患者维持了复位(KI),马吉德评分在72至96分之间(7例良好,3例优秀)。

讨论

INFIX手术后的感染通过伤口冲洗和清创、取出INFIX并使用针对性培养的抗生素治疗2 - 6周来处理。植入物保留至少25天,且无复位丢失。在这个小样本系列以及本文纳入的文献综述中均未发现长期后遗症。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2bf4/8425278/acd8f5372d7c/sicotj-7-46-fig1.jpg

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