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揭示被忽视的克氏针固定部位结核:因采用克氏针治疗桡骨远端骨折而罕见遭遇的病例

Unveiling Neglected Pin-Site Tuberculosis: An Uncommon Encounter Due to Surgical Distal-End Radius Fracture Management With K-Wires.

作者信息

Patel Hardik, Pundkar Dr Aditya, Shrivastava Sandeep, Ambatkar Suyash Y, Goyal Saksham

机构信息

Department of Orthopaedics, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND.

出版信息

Cureus. 2024 Feb 10;16(2):e53986. doi: 10.7759/cureus.53986. eCollection 2024 Feb.

Abstract

In this case report, a 29-year-old man underwent surgery to treat a fracture to the left distal end of his radius using closed reduction and K-wire fixation. The patient was advised to follow up in the outpatient department after six weeks for cast and K-wire removal. Still, the patient failed to do so and was doing alternate day dressing of the K-wires. After six months he slipped and fell from his cot while sleeping, sustaining an injury to the left wrist. Initially, he developed a swelling over the wrist, which suddenly increased in size and ruptured. Thick white caseous material was leaking out from the wounds. The patient underwent debridement and K-wire removal. An intraoperative sample was sent for a bacterial culture sensitivity test, histological analysis, and cartridge-based nucleic acid amplification test (CB-NAAT/GeneXpert). Postoperatively, anti-tuberculous treatment was started. The patient fully recovered from tuberculosis and had a complete range of movements after treatment.

摘要

在本病例报告中,一名29岁男性接受了手术,采用闭合复位和克氏针固定治疗左桡骨远端骨折。建议患者六周后到门诊拆除石膏和克氏针。然而,患者并未照做,而是每隔一天对克氏针进行换药。六个月后,他睡觉时从床上滑落,左手腕受伤。最初,他手腕处出现肿胀,随后肿胀突然增大并破裂。伤口有浓稠的白色干酪样物质渗出。患者接受了清创和克氏针取出术。术中样本被送去进行细菌培养药敏试验、组织学分析以及基于 cartridge 的核酸扩增试验(CB-NAAT/ GeneXpert)。术后开始抗结核治疗。患者的结核病完全康复,治疗后关节活动范围正常。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/932c/10928017/5e78d9117ae0/cureus-0016-00000053986-i01.jpg

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本文引用的文献

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A rare localization of tuberculosis of the wrist: The scapholunate joint.
Int J Mycobacteriol. 2015 Jun;4(2):161-4. doi: 10.1016/j.ijmyco.2015.04.001. Epub 2015 Apr 30.
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