ROLE OF ANTIBIOTIC IMPREGNATED CEMENT COATED INTRAMEDULLARY NAILING IN ORTHOPAEDICS
Authors/Creators
- 1. Professor and HOD, Department of Orthopaedics, Sri Aurobindo Medical College and Post Graduate Institute, Indore, Madhya Pradesh, India.
- 2. Senior Resident, Department of Orthopaedics, Sri Aurobindo Medical College and Post Graduate Institute, Indore, Madhya Pradesh, India.
- 3. PG Resident, Department of Orthopaedics, Sri Aurobindo Medical College and Post Graduate Institute, Indore, Madhya Pradesh, India.
Description
Introduction:Traditionally,thetreatmentstrategyofinfectednon-unionconsistedofsurgicaldebridementandthenasecondprocedureforstability.Theuseofanantibioticcementednailingforinfectednon-unionoftibiaandfemurfracturesavoidstheneedofmorethan1procedureasthenailprovidesstabilityandallowshigherconcentrationofantibioticatthelocalsitethanisachievablewithsystemicantibioticsandisassociatedwithfewersideeffect.
MaterialandMethods:Thisisaprospectivestudyof12patientswithdiaphysealfractureoftibiaorfemurwithsignsofinfectionwhoweretreatedusingantibioticcementednailing.Patientswerefollowedupmonthlyfor3months.Infectioncontrolwasevaluatedintermsofclinical,haematologicalandmicrobiologicalparameters.
Results:Atthetimeofpresentation11outof12patientshadpusdischarge,whilelocalriseoftemperaturewasthereinallpatients.MostcommonorganismthatwasisolatedincultureswasStaphylococcusaureus.ESRandCRPwaselevatedin9patients.At3monthsfollowupvisit,9outof12patientsresolvedallsignsofinfectionwhile1hadpersistentpositiveculturereports.ESRandCRPwasraisedin3and2patientsrespectively.
Conclusion:Antibioticcementednailingdeliversahighconcentrationofantibioticsatthelocalsitewithoutcausinganysystemictoxicityalongwithprovidingstabilityatthefracturesite,therebyconvertingatwo-stageprocedureintoasinglestageprocedurewhichalsoavoidscomplicationsofexternalfixatorhavingbetterpatientcompliance.
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