An Interventional Study on Antibiotic Cement-coated Nails and Cement Beads in the Management of Infected Nonunion of Long Bones
SV Sunny Deol, N Rajkumar, V Arul Jothi, Murali Mothilal
Antibiotic cement-coated nails, Cement beads, Infected long bone
Citation Information :
Deol SS, Rajkumar N, Jothi VA, Mothilal M. An Interventional Study on Antibiotic Cement-coated Nails and Cement Beads in the Management of Infected Nonunion of Long Bones. 2021; 3 (2):76-79.
Background: The present study was aimed to assess the efficacy of antibiotic cement-coated nails and cement beads among the cases of infected nonunion of long bones.
Materials and methods: This prospective interventional study was conducted among the cases admitted in the emergency and outpatient department of Orthopedics in Patna Medical College and Hospital, Patna, with infected nonunion of long bones, during the month of June 2010 to August 2012. All cases with an infected nonunion of extremities with implants were included. A total of 44 cases were included. Data analysis was done using SPSS version 17.
Results: In this study, out of 44 infected nonunion, 40 were cured of infection, 3 cases had occasional discharge, and 1 case had a continuous discharge. Secondary procedures were done for the 40 cured cases and among them, 37 showed complete achievement of union, and 3 cases had occasional discharge and no case had a continuous discharge.
Conclusion: The use of antibiotic cement-coated nails and cement beads among the cases with infected nonunion of long bones significantly reduced the requirement of a further surgical procedure like debridement of the wound site.
Lee SJ, Jang DW, Kim TS, et al. Treatment of chronic osetomyelitis by saucerization and gentamicin-PMMA beads. J Korean Orthop Assoc 1989;24(2):549–556. DOI: 10.4055/jkoa.1918.104.22.1689.
Court-Brown CM. Fractures of the tibia and fibula. In: Bucholz RW, Heckman JD, Court-Brown CM, ed. Rockwood and Green's fractures in adults. 6th ed., Lippincott Williams and Wilkins; 2006. pp. 2080–2146.
Patzakis MJ, Zalavras CG. Chronic posttraumatic osteomyelitis and infected nonunion of the tibia: current management concepts. J Am Acad Orthop Surg 2005;13(6):417–427. DOI: 10.5435/00124635-200510000-00006.
Buchholz HW, Engelbrecht H. Uber die depotwirkung einiger antibiotica bei vermischung mit dem kunstharz palacos. Chirurg 1970;41(11):511–515.
Klemm K. Gentamycin-PMMA-kugeln in der behandlung abszedierender knochen- und weichteilinfektionen. Zentralbl Chir 1979;104(14):934–942.
Toh CL, Jupiter JB. The infected nonunion of the tibia. Clin Orthop Relat Res 1995;315(315):176–191. DOI: 10.1097/00003086-199506000-00019.
Wu CC, Shih CH. Distal tibial nonunion treated by intramedullary reaming with external immobilization. J Orthop Trauma 1996;10(1):45–49. DOI: 10.1097/00005131-199601000-00007.
Paley D, Herzenberg JE. Intramedullary infections treated with antibiotic cement rods: preliminary results in nine cases. J Orthop Trauma 2002;16(10):723–915. DOI: 10.1097/00005131-200211000-00007.
Qiang Z, Jun PZ, Jie XJ, et al. Use of antibiotic cement rod to treat intramedullary infection after nailing: preliminary study in 19 patients. Arch Orthop Trauma Surg 2007;127(10):945–951. DOI: 10.1007/s00402-007-0315-x.
Maini L, Chadha M, Vishwanath J, et al. The Ilizarov method in infected nonunion of fractures. Injury 2000;31(7):509–517. DOI: 10.1016/s0020-1383(00)00036-x.
Song HR, Cho SH, Koo KH, et al. Tibial bone defects treated by internal bone transport using the Ilizarov method. Int Orthop 1998;22(5):293–297. DOI: 10.1007/s002640050263.
Stans AA, Morrissy RT, Renwick SE. Femoral shaft fracture treatment in patients age 6 to 16 years. J Pediatr Orthop 1999;19(2):222–228. DOI: 10.1097/01241398-199903000-00017.
Jain AK, Sinha S. Infected nonunion of the long bones. Clin Orthop Relat Res 2005;431:57–65. DOI: 10.1097/01.blo.0000152868.29134.92.
Struijs PA, Poolman RW, Bhandari M. Infected nonunion of the long bones. J Orthop Trauma 2007;21(7):507–511. DOI: 10.1097/BOT.0b013e31812e5578.
Shahcheraghi GH, Bayatpoor A. Infected tibial nonunion. Can J Surg 1994;37(3):209–213.
Eshima I, Feibel RJ, Louie KW, et al. Combined muscle flap and Ilizarov reconstruction for bone and soft tissue defects. Clin Orthop Relat Res 1996;332(332):37–51. DOI: 10.1097/00003086-199611000-00007.
Donati D, Biscaglia R. The use of antibiotic-impregnated cement in infected reconstructions after resection for bone tumours. J Bone Joint Surg Br 1998;80(6):1045–1050. DOI: 10.1302/0301-620x.80b6.8570.
Zuluaga AF, Galvis W, Jaimes F, et al. Lack of microbiological concordance between bone and non-bone specimens in chronic osteomyelitis: an observational study. BMC Infect Dis 2002;16(1):2–8. DOI: 10.1186/1471-2334-2-8.
Akinyoola AL, Adegbehingbe OO, Aboderin AO. Therapeutic decision in chronic osteomyelitis: sinus track culture versus intraoperative bone culture. Arch Orthop Trauma Surg 2009;129(4):449–453. DOI: 10.1007/s00402-008-0621-y.
Joshi D, Ahmed A, Krishna L, et al. Unreamed interlocking nailing in open fractures of tibia. J Orthop Surg (Hong Kong) 2004;12(2):216–221. DOI: 10.1177/230949900401200215.
Coles CP, Gross M. Closed tibial shaft fractures: management and treatment complications: a review of the prospective literature. Can J Surg 2000;43(4):256–262.
May JW, Jupiter JB, Weiland AJ, et al. Clinical classification of post-traumatic tibial osteomyelitis. J Bone Joint Surg Am 1989;71(9):1422–1428. DOI: 10.2106/00004623-198971090-00027.
Shyam AK, Sancheti PK, Patel SK, et al. Use of antibiotic cement-impregnated intramedullary nail in treatment of infected non-union of long bones. Indian J Orthop 2009;43(4):396. DOI: 10.4103/0019-5413.55468.
Thonse R, Conway J. Antibiotic cement-coated interlocking nail for the treatment of infected nonunions and segmental bone defects. J Orthop Trauma 2008;21(4):258–688. DOI: 10.1097/BOT.0b013e31803ea9e6.