Department of Orthopedics Surgery, Orthopedic Research Institute, West China Hospital of Sichuan University, Chengdu, China.
Trauma Center, West China Hospital of Sichuan University, Chengdu, China.
BMC Musculoskelet Disord. 2024 Aug 3;25(1):620. doi: 10.1186/s12891-024-07747-w.
The Internal Fixator (INFIX) is a popular method, known for its minimal invasiveness and short operation time, for treating anterior pelvic ring fractures. Studies have shown that postoperative complications may occur, including anterolateral femoral cutaneous nerve injury, the femoral nerve paralysis, and delayed fracture healing. These complications are believed to be related to surgical stimulation, an excessively long lateral end of the connecting rod, a small distance between the screw and bone surface, insufficient pre-bending of the connecting rod, and difficulties in fracture reduction.
We report two unique cases of lower abdominal pseudocyst complicated with suspected infection after INFIX treatment of pelvic fractures at our trauma center. Following surgical removal of the internal fixation, resolution of the cysts was observed in both patients, and subsequent postoperative follow-up revealed the absence of any residual sequelae. These cases have not been reported in previous literature reviews.
The lower abdominal cysts, potentially arising from the dead space created during intraoperative placement of the INFIX rod, may increase infection risk. The etiology remains uncertain, despite the presence of abnormal inflammation markers in both cases, and staphylococcus aureus found in one. These cysts were confined to the lower abdomen, not involving the internal fixation, and hence, only the INFIX was removed. Postoperative oral cefazolin treatment was successful, with resolved pseudocysts and no subsequent discomfort.
We report two unprecedented cases of post-INFIX abdominal cysts, with a suspected link to intraoperative dead space. Despite uncertain etiology, successful management involved INFIX removal and oral cefixime therapy. These findings necessitate further exploration into the causes and management of such complications.
内固定器（INFIX）是一种治疗骨盆前环骨折的常用方法，以微创和手术时间短为特点。研究表明，术后可能会出现并发症，包括股前外侧皮神经损伤、股神经麻痹和骨折愈合延迟。这些并发症被认为与手术刺激、连接杆过长、螺钉与骨面之间的距离过小、连接杆预弯曲不足以及骨折复位困难有关。
我们报告了两例在我院创伤中心使用 INFIX 治疗骨盆骨折后出现下腹部假性囊肿并疑似感染的独特病例。在取出内固定物后，两名患者的囊肿均得到缓解，随后的术后随访显示没有任何残留后遗症。这些病例在以前的文献综述中没有报道过。
下腹部囊肿可能是由于 INFIX 杆术中放置时产生的死腔引起的，可能会增加感染风险。尽管在两个病例中都存在异常炎症标志物，且一个病例中发现了金黄色葡萄球菌，但病因仍不确定。这些囊肿局限于下腹部，不涉及内固定物，因此只切除了 INFIX。术后口服头孢唑啉治疗成功，假性囊肿消失，无后续不适。
我们报告了两例罕见的 INFIX 术后腹部囊肿病例，疑似与术中死腔有关。尽管病因不确定，但成功的治疗方法包括 INFIX 切除和口服头孢克肟治疗。这些发现需要进一步探讨此类并发症的原因和治疗方法。
