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锁骨骨折所致血源性骨髓炎:保守治疗后的罕见并发症

[Hematogenous osteomyelitis due to clavicular fracture : A rare complication after conservative treatment].

作者信息

Dezulovic M, Hönck K, Palle W, Bürger H

机构信息

Abteilung für Orthopädie und Traumatologie, Krankenhaus des Deutschen Ordens Friesach, St. Veiter Straße 12, 9360, Friesach, Österreich.

Abteilung für Orthopädie und Traumatologie, Universitätsklinik Graz, Graz, Österreich.

出版信息

Unfallchirurgie (Heidelb). 2022 Nov;125(11):915-920. doi: 10.1007/s00113-022-01149-0. Epub 2022 Feb 17.

Abstract

We present a case of a nondislocated clavicular fracture that was conservatively treated for 4 weeks with a sling. The patient was a smoker and suffered from type 2 diabetes mellitus. After 2 months a suppurative infection occurred due to an escalation based on a clavicular osteomyelitis. Through antibiotic treatment and an aggressive surgical approach the infection was cured but ended up with a painful malunion of the clavicle. The bone reconstruction was achieved with a long locking plate with an additional vascularized medial femoral condyle free flap. After 18 months the patient was subjectively very satisfied with the outcome, had no pain and excellent functional results in the Constant Murley and DASH (Disabilities of Arm, Shoulder and Hand) scores. The X‑ray assessment showed full bone union.

摘要

我们报告一例非脱位性锁骨骨折病例,该患者使用吊带保守治疗4周。患者为吸烟者,患有2型糖尿病。2个月后,因锁骨骨髓炎病情进展出现化脓性感染。通过抗生素治疗和积极的手术方法,感染得以治愈,但最终锁骨出现疼痛性畸形愈合。采用长锁定钢板并附加带血管蒂的股骨内侧髁游离皮瓣进行骨重建。18个月后,患者主观上对治疗结果非常满意,无疼痛,Constant Murley评分和DASH(上肢、肩部和手部功能障碍)评分显示功能结果极佳。X线评估显示骨完全愈合。

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