实用临床医药杂志2024，Vol.28Issue(24)：77-81,87,6.DOI:10.7619/jcmp.20244272
髌骨骨折内固定术后感染的诊治方案选择及疗效分析
Selection of diagnostic and therapeutic regimens and efficacy analysis for postoperative infection following internal fixation of patellar fractures
摘要
Abstract
Objective To explore the selection strategy of diagnostic and therapeutic regimens and assess the efficacy for postoperative infection following internal fixation of patellar fractures.Meth-ods A retrospective analysis was conducted on the clinical data of 12 patients with postoperative in-fection after internal fixation of patellar fractures.Results A total of 6 patients underwent complete removal of the internal fixation devices during debridement and were subsequently fixed with knee braces,while the other 6 had their original internal fixation devices removed and replaced with Kir-schner wire fixation.Three patients developed septic arthritis and underwent knee arthroscopic lavage treatment.All 12 patients underwent bacterial culture and metagenomic next-generation sequencing(mNGS)testing,and the key pathogenic bacteria were successfully identified by mNGS.All wounds achieved primary healing within 2 weeks after closure.At the final follow-up,all patients exhibited good fracture healing,with Böstman patellar fracture function scores ranging from 24 to 29(mean score of 26.58),and the outcomes were evaluated as excellent in 7 cases and good in 5,resulting in an ex-cellent and good rate of 100.0％.Conclusion For patients with early and delayed postoperative in-fections following internal fixation of patellar fractures,removal of the internal fixation devices can help reduce the risk of infection recurrence.For patients with concurrent septic arthritis,early diagnosis and timely implementation of arthroscopic joint debridement and irrigation and drainage are crucial.关键词
髌骨骨折/内固定术/术后感染/化脓性关节炎/关节镜/宏基因二代测序技术Key words
patellar fracture/internal fixation/postoperative infection/septic arthritis/arthro-scopy/metagenomic next-generation sequencing分类
医药卫生引用本文复制引用
程晖,杨奇宏,万斌,王锦文,刘晟宇,胡军..髌骨骨折内固定术后感染的诊治方案选择及疗效分析[J].实用临床医药杂志,2024,28(24):77-81,87,6.基金项目
国家自然科学基金项目(82272544) （82272544）
