Outcomes of Various Antibiotic Cement–Coated Intramedullary Implants on the Treatment of Long Bone Septic Nonunion
| Autor: | Luke A. Lopas, Anjan R. Shah, Hassan R. Mir, David T. Watson, Spencer Albertson, Anthony Infante, Roy Sanders, Katheryne Downes, Eric Solomon, David Donohue, Ben Maxson |
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| Rok vydání: | 2022 |
| Předmět: |
medicine.medical_specialty
medicine.drug_class medicine.medical_treatment Antibiotics Long bone Nonunion Bone Nails medicine.disease_cause law.invention Weight-bearing Intramedullary rod law medicine Humans Orthopedics and Sports Medicine Retrospective Studies Fracture Healing business.industry Trauma center General Medicine Antibiotic cement medicine.disease Anti-Bacterial Agents Fracture Fixation Intramedullary Surgery Tibial Fractures Treatment Outcome medicine.anatomical_structure Amputation business |
| Zdroj: | Journal of Orthopaedic Trauma. 36:44-50 |
| ISSN: | 0890-5339 |
| Popis: | To determine the effectiveness of various types of antibiotic-coated intramedullary implants in the treatment of septic long bone nonunion.Retrospective chart review.Level 1 trauma center.Forty-one patients with septic long bone nonunion treated with an antibiotic cement-coated intramedullary implant.Surgical debridement and placement of a type of antibiotic-coated intramedullary implant.Union and need for reoperation.At an average 27-month follow-up (6-104), 27 patients (66%) had a modified radiographic union score of the tibia of 11.5 or greater, 12 patients (29%) a score lower than 11.5, and 2 patients (5%) underwent subsequent amputation. Six patients underwent no further surgical procedures after the index operation. Patients treated with a rigid, locked antibiotic nail achieved earlier weight-bearing (P = 0.001), less frequently required autograft (P = 0.005), and underwent fewer subsequent procedures (average 0.38 vs. 3.60, P = 0.004) than those treated with flexible core antibiotic rods.Antibiotic-coated intramedullary implants are successful in the treatment of septic nonunions in long bones. In our cohort, rigid, statically locked nails allowed faster rehabilitation, decreased the need for autograft, and decreased the number of additional surgical procedures. Further study is needed to confirm these findings.Therapeutic Level III. See Instructions for Authors for a complete description of levels of evidence. |
| Databáze: | OpenAIRE |
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