Eijkenboom Alexander, Militz Matthias, Papetti Maurizio, Krenn Veit, Hackl Simon
Department of Septic and Reconstructive Surgery, BG Unfallklinik Murnau, Murnau am Staffelsee, DEU.
Department of Pathology, MVZ Institute of Pathology, Trier, DEU.
Cureus. 2024 Aug 2;16(8):e65988. doi: 10.7759/cureus.65988. eCollection 2024 Aug.
Fracture-related infections caused by mucormycosis are rare and potentially fatal. Evidence-based experience with its treatment is limited, and surgical management ranges from limb salvage to amputation, with indications not always clear. A 56-year-old woman was admitted after an aircraft accident, sustaining major trauma injuries, including a Gustilo-Anderson type III open ankle joint fracture. Initial damage control surgery with external fixation ensued, followed by secondary, definitive internal fixation with plate and screws. The patient developed a fracture-related infection in the ankle caused by . Despite its invasive growth and tenacity, surgical debridement combined with systemic and local antifungal therapy led to remission in this immunocompetent patient. The ankle arthrodesis achieved bone union with a hexapod fixator 10 months post-trauma. In the treatment of opportunistic invasive mucormycosis, a multidisciplinary approach is necessary, especially in patients suffering major trauma injuries. Through apt diagnosis and thorough treatment by experienced surgeons, infectiologists, and pathologists, successful limb salvage may be attained in patients with an otherwise intact immune system, and amputation can be prevented.
由毛霉菌病引起的骨折相关感染罕见且可能致命。其治疗的循证经验有限，手术处理范围从保肢到截肢，指征并不总是明确。一名56岁女性在飞机事故后入院，遭受了包括Gustilo-Anderson III型开放性踝关节骨折在内的严重创伤。随后进行了外固定的初始损伤控制手术，接着进行了钢板和螺钉的二期确定性内固定。患者踝关节发生了由……引起的骨折相关感染。尽管其具有侵袭性生长和韧性，但手术清创联合全身及局部抗真菌治疗使这位免疫功能正常的患者病情缓解。创伤后10个月，踝关节融合术通过六足固定器实现了骨愈合。在治疗机会性侵袭性毛霉菌病时，多学科方法是必要的，尤其是在遭受严重创伤的患者中。通过经验丰富的外科医生、感染病学家和病理学家的准确诊断和彻底治疗，免疫系统 otherwise intact 的患者可能成功保肢，并可避免截肢。 （注：原文中“caused by.”后面内容缺失）
