Department of Orthopaedic Surgery, University of Minnesota Medical School, Minneapolis, Minnesota.
Department of Orthopaedic Surgery, Regions Hospital, St. Paul, Minnesota.
JBJS Case Connect. 2023 Jan 31;13(1). doi: e22.00606. eCollection 2023 Jan 1.
A 47-year-old man crushed between 2 cars during a demolition derby, a nonracing North American motorsport, underwent open reduction and internal fixation, iliosacral screw fixation, arterial embolization, and multiple urologic procedures after massive pelvic ring injury, remarkably recovering nearly full function. Sixteen years after injury, he developed an abscess emanating from an iliosacral screw requiring irrigation, debridement, and hardware removal.
Deep surgical infections from iliosacral screws may present late, even more than 15 years after the original surgery. Obesity, preoperative embolization, diabetes, and urethral injuries are relevant risk factors. Similar patients should have a low threshold for infection workup when presenting with symptoms, even years after surgery.
一名 47 岁男子在汽车拆卸比赛（一种非竞速性的北美汽车运动）中被两辆汽车挤压，发生严重骨盆环损伤后，接受了切开复位内固定、髂骨骶骨螺钉固定、动脉栓塞以及多次泌尿科手术，其功能几乎完全恢复。受伤 16 年后，他出现了从髂骨骶骨螺钉处发出的脓肿，需要进行灌洗、清创和去除硬件。
髂骨骶骨螺钉的深部手术感染可能会延迟出现，甚至在最初手术后 15 年以上。肥胖、术前栓塞、糖尿病和尿道损伤是相关的危险因素。对于出现症状的类似患者，即使在手术后多年，也应在感染检查方面有较低的门槛。
