Abstract

MINORU ISOBE, Federico et al. Prótesis total de fémur en un paciente con quiste óseo hidatídico complicado. Reporte de un caso. Rev. Asoc. Argent. Ortop. Traumatol. [online]. 2020, vol.85, n.3, pp.262-269. ISSN 1852-7434.  http://dx.doi.org/https://doi.org/10.15417/issn.1852-7434.2020.85.3.1036.

We report the case of a 31-year-old male patient presenting a femoral fracture whose complementary studies revealed an image consistent with a cystic lesion. The first biopsy study of this cyst erroneously reported a simple cyst. Osteosynthesis with intramedullary nailing was performed. The patient had a poor postoperative course associated with diaphyseal osteolytic images and loss of fracture reduction. The material was removed and intramedullary canal specimens were taken, which were positive for Pseudomonas aeruginosa and revealed remains of hydatid cysts through pathologic examination. The patient was referred to our center for the treatment of an infected pseudarthrosis secondary to a complicated hydatid bone cyst. A two-stage procedure was performed. The first stage involved the placement of an antibiotic-impregnated cement mega-spacer and the second stage involved the implantation of a total femur prosthesis as definitive treatment. The bone hydatidosis involves a challenging diagnosis, is very rare, and can cause severe dissemination. While there is no consensus or gold standard treatment for severe cases, two-stage total femoral replacement represents an encouraging option for limb preservation, showing satisfactory short- and medium-term outcomes.

Keywords : Complicated hydatid cyst; hip mega-prosthesis; infected pseudarthrosis.

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