RESUMEN
We describe the methodical and possibilities of 3D surgical printing in preoperative planning of acetabular fractures showing a case of a 45-year-old with an associated transverse fracture of the left acetabulum with posterior wall fracture, with multiple fragments, and posterior ipsilateral hip dislocation, defending the do it your-self mode.
Asunto(s)
Acetábulo/lesiones , Fijación Interna de Fracturas/métodos , Fracturas Óseas/cirugía , Luxación de la Cadera/cirugía , Impresión Tridimensional , Accidentes de Tránsito , Acetábulo/anatomía & histología , Placas Óseas , Análisis Costo-Beneficio , Fijación Interna de Fracturas/instrumentación , Fracturas Óseas/diagnóstico por imagen , Luxación de la Cadera/diagnóstico por imagen , Humanos , Persona de Mediana Edad , Periodo Preoperatorio , Impresión Tridimensional/economía , Impresión Tridimensional/instrumentación , Tiempo de Tratamiento , Resultado del TratamientoRESUMEN
Retained sponges after a surgical treatment of polytrauma may cause a broad spectrum of clinical symptoms and present a difficult diagnostic problem. We report a case of retained surgical sponge in a 35-year-old man transferred from another hospital, that sustained a open acetabular fracture. The fracture was reduced through a limited ilio-inguinal approach. After 4 days, he presented massive wound dehiscence of the surgical approach. An abdominal CT scan showed, lying adjacent to the outer aspect of the left iliac crest, a mass of 10 cm, identified as probable foreign body. The possibility of this rare complication should be in the differential diagnosis of any postoperative patient who presents with pain, infection, or palpable mass.
RESUMEN
Sequential compression devices and chemical prophylaxis are the standard venous thromboembolism (VTE) prevention for trauma patients with acetabular and pelvic fractures. Current chemical pharmacological contemplates the use of heparins or fondaparinux. Other anticoagulants include coumarins and aspirin, however these oral agents can be challenging to administer and may need monitoring. When contraindications to anticoagulation in high-risk patients are present, prophylactic inferior vena cava filters can be an option to prevent pulmonary emboli. Unfortunately strong evidence about the most effective method, and the timing of their commencement, in patients with pelvic and acetabular fractures remains controversial.
