Tapsoba Wendlamita Toussaint, Ouédraogo Somkièta Modeste Francis, Béré Bernadette, Ganamé Saïd Nahl Oumar, Koundia Thombiano, Zampou Oliver, Isso Ouédraogo, Emile Bandré
Service de Chirurgie pédiatrique du Centre Hospitalier Universitaire Pédiatrique Charles de Gaulle de Ouagadougou, Ouagadougou, Burkina Faso.
Pan Afr Med J. 2023 Oct 3;46:49. doi: 10.11604/pamj.2023.46.49.41650. eCollection 2023.
Scapulothoracic dissociation due to a trauma is exceptional. The purpose of this study was to share our experience with a case of scapulothoracic dissociation and to explain the advantages of our approach. We report the case of a 12-year-old right-handed schoolgirl admitted to hospital with a blunt trauma to the right thoracic limb complicated by infection after a week of traditional treatment (massage, bandaging with reed splints). Surgical neck fracture of the right humerus complicated by wet gangrene of the entire limb and severe anaemia was diagnosed. Blood transfusion, triple antibiotic therapy and scapulohumeral disarticulation were required. Progressive excision of necrotic tissue followed by scapulectomy (day 24) for scapular necrosis made it possible to sterilise the site and to perform a skin graft (day 43). The patient was discharged after 2 months. Physiotherapy was combined with psychological treatment and the patient had a simple post-operative course during the 7-month follow-up period. Failure of conventional treatment for limb fractures can be life-threatening and cause severe sequelae.
因创伤导致的肩胛胸壁分离极为罕见。本研究的目的是分享我们处理一例肩胛胸壁分离病例的经验,并阐述我们治疗方法的优势。我们报告了一名12岁右利手女学生的病例,她因右上肢钝器伤入院,在接受一周的传统治疗(按摩、用芦苇夹板包扎)后并发感染。诊断为右肱骨外科颈骨折,并发全肢湿性坏疽和严重贫血。需要输血、三联抗生素治疗以及肩胛肱骨离断术。逐步切除坏死组织,随后因肩胛骨坏死在第24天行肩胛骨切除术,从而实现创口消毒并在第43天行植皮术。患者在2个月后出院。物理治疗与心理治疗相结合,患者在7个月的随访期内术后恢复过程顺利。四肢骨折传统治疗失败可能危及生命并导致严重后遗症。