Department of Orthopedic Surgery, Dayanand Medical College & Hospital, Ludhiana, Punjab (India).
J Orthop Trauma. 2012 Mar;26(3):184-8. doi: 10.1097/BOT.0b013e318225f77c.
This study looks at the treatment of 16 cases of infection in long bone fractures that had an adverse effect on healing. The goal was to find a method that may be effective in getting these most difficult injuries to heal. The use of reinforced antibiotic-impregnated bone cement rods was studied to see if this could be an effective form of treatment. The use of such devices makes sense because they provide stability that the fractures need for healing while also providing a high concentration of antibiotics locally. The concept was to reduce the amount of metal used for stability while still giving the fracture the correct milieu for healing.
This was a retrospective analysis of 16 patients with infected nonunions of long bones. A protocol for the use of intravenous and per oral antibiotics was developed based on the type of bacteria found from cultures of the infected sites. All cases included operative débridement and stabilization with a reinforced antibiotic-impregnated bone cement rod.
The patient population was selected from all those who presented to the Department of Orthopaedic Surgery of Dayanand Medical College & Hospital, Ludhiana, India.
Success was considered when the nonunion healed and the limb became functional.
The infected nonunions were treated successfully in 14 of 16 cases. This represents an alternative to external fixation alone as a means of stabilizing nonunions while providing a high concentration of antibiotic locally for combating this most difficult problem.
The use of reinforced antibiotic-impregnated bone cement rods with appropriate surgical débridement and antibiotics may be an effective way of treating infected nonunions of long bones.
Therapeutic Level IV. See page 128 for a complete description of levels of evidence.
本研究观察了 16 例对愈合有不良影响的长骨骨折感染的治疗方法。目的是寻找一种可能有效的方法来治疗这些最困难的损伤。研究了使用强化抗生素浸渍骨水泥棒是否可以作为一种有效的治疗方法。这种装置的使用是有意义的，因为它们在为骨折愈合提供稳定性的同时，还可以在局部提供高浓度的抗生素。其理念是减少用于稳定性的金属用量，同时仍为骨折提供正确的愈合环境。
这是对 16 例长骨感染性骨不连患者的回顾性分析。根据感染部位培养出的细菌类型，制定了使用静脉和口服抗生素的方案。所有病例均包括手术清创和强化抗生素浸渍骨水泥棒固定。
患者人群选自印度卢迪亚纳的 Dayanand 医学院和医院骨科就诊的所有患者。
当骨不连愈合且肢体功能恢复时，视为成功。
16 例感染性骨不连中有 14 例成功治疗。这是一种替代单独外固定的方法，可在提供局部高浓度抗生素以对抗这一最困难问题的同时，为骨不连提供稳定性。
使用强化抗生素浸渍骨水泥棒，结合适当的手术清创和抗生素治疗，可能是治疗长骨感染性骨不连的有效方法。
治疗性 IV 级。如需完整的证据水平描述，请参见第 128 页。
