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闭合性骨盆环损伤合并远处伤口时遭遇盆腔结核——术中意外:一例病例报告

Encountering pelvic tuberculosis in closed pelvic ring injury with distant wound - An intraoperative surprise: A case report.

作者信息

Patil Atul, Rapole Sanika, Vinayak Udit, Sancheti Parag

机构信息

Sancheti Institute for Orthopedics and Rehabilitation Pune, Maharashtra, India.

出版信息

Trauma Case Rep. 2023 Feb 8;44:100784. doi: 10.1016/j.tcr.2023.100784. eCollection 2023 Apr.

Abstract

Delayed presentation of closed APC type III pelvic ring injury with a healing wound on the medial thigh, in a twenty-six-year-old male, at four weeks. We planned Symphyseal plating and sacroiliac screw fixation surgery. After percutaneous screw fixation, subsequent pelvic exposure revealed whitish cheesy pus in the retropubic space. Hence, we changed surgery from internal fixation to a supra-acetabular external fixator. Subsequent molecular testing documented tuberculosis and regimen of antitubercular medications was started. Complete functional recovery was observed at 12 months. While managing pelvic injuries, alternative backup treatment plans should be kept ready in view of infective foci.

摘要

一名26岁男性在四周时出现闭合性APC III型骨盆环损伤延迟就诊,大腿内侧有愈合伤口。我们计划行耻骨联合钢板固定和骶髂螺钉固定手术。经皮螺钉固定后,随后的骨盆暴露显示耻骨后间隙有白色干酪样脓液。因此,我们将手术从内固定改为髋臼上外固定架。随后的分子检测证实为结核病,并开始了抗结核药物治疗方案。12个月时观察到完全功能恢复。在处理骨盆损伤时,鉴于感染灶,应随时准备好替代的备用治疗方案。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/645f/9945763/4fd4aa5db221/gr1.jpg

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