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外固定后针道蝇蛆病:1例病例报告及文献复习

Pin-tract myiasis after external bone fixation: A case report and review of literature.

作者信息

Lageju Nimesh, Neupane Durga, Jaiswal Lokesh Shekher, Phuyal Upama

机构信息

MBBS, B.P. Koirala Institute of Health Sciences, Dharan, Nepal.

MBBS, B.P. Koirala Institute of Health Sciences, Dharan, Nepal.

出版信息

Int J Surg Case Rep. 2022 Jun;95:107247. doi: 10.1016/j.ijscr.2022.107247. Epub 2022 May 24.

Abstract

INTRODUCTION AND IMPORTANCE

Myiasis has been reported as a complication of fracture treatment with external fixation. Therefore, physicians should be aware of the possible re-emergence of myiasis as a complication of surgery and the use of metal fixators.

CLINICAL PRESENTATION

A 45-year-old male, non-diabetic, chronic alcoholic treated with external bone fixation and flap coverage for Gustilo-Anderson type IIIB comminuted fracture of shaft of left tibia and fibula with intact distal neuro-vascular system presented with multiple maggots with foul-smelling discharge from the pin tract. A diagnosis of abscess with pin-tract myiasis was made and managed with wound debridement and complete removal of maggots.

CONCLUSION

We report this rare pin-tract complication to acknowledge how simple precautions, wound care, and avoidance of risk factors play a vital role in preventing such infestations. Therefore, physicians should be aware of the possible re-emergence of myiasis as a complication of surgery and the use of metal fixators.

摘要

引言与重要性

蝇蛆病已被报道为外固定治疗骨折的一种并发症。因此,医生应意识到蝇蛆病作为手术及金属固定器使用的并发症可能再度出现。

临床表现

一名45岁男性,非糖尿病患者,慢性酒精中毒者,因左胫腓骨干Gustilo-Anderson IIIB型粉碎性骨折接受外固定及皮瓣覆盖治疗,远端神经血管系统完整,其针道出现多条蛆虫并有恶臭分泌物。诊断为针道脓肿合并蝇蛆病,并通过伤口清创及彻底清除蛆虫进行处理。

结论

我们报告这一罕见的针道并发症,以认识到简单的预防措施、伤口护理及避免危险因素在预防此类感染中发挥的重要作用。因此,医生应意识到蝇蛆病作为手术及金属固定器使用的并发症可能再度出现。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ca64/9149183/647851226ebe/gr1.jpg

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