Bharti Ajay, Saroj Umesh Kumar, Kumar Vineet, Kumar Sanjay, Omar Balram Ji
GSVM Medical College, Kanpur, UP, India.
Govt. Medical College, Azamgarh, UP, India.
J Clin Orthop Trauma. 2016 Oct-Dec;7(Suppl 2):171-176. doi: 10.1016/j.jcot.2016.08.004. Epub 2016 Aug 31.
The intramedullary insertion of antibiotic impregnated PMMA rods, beads or nails are widely used and accepted modality of treatment for chronic osteomyelitis of long bones. But at times it becomes difficult to insert and remove these antibiotic delivery systems owing to narrowed medullary canals. Here we present a technique for preparing PMMA rods with diameter ranging from 6 mm to 3 mm. These rods could easily be placed in narrow intramedullary canal of long bones with chronic osteomyelitis or infected non-union. We have used high viscosity bone cement (Simplex P) along with two antibiotics (cefuroxime and vancomycin) for preparing cement rods. Food grade straw and low profile teflon tube guide wire exchanger used in IM nailing were used as mold. Ilizarov wire, 1 mm K wire and 24 gauge stainless steel wire were used as internal support core material for imparting strength. We used this technique in seven cases and were successful in treating infection of long bones of upper and lower limbs (femur). With average follow up of 7.28 months rate of union in our series was 71% (five cases). Four cases (57%) had no evidence of infection and two cases (29%) had control of infection and in one case (14%) infection was still there but union was achieved.
抗生素浸渍的聚甲基丙烯酸甲酯(PMMA)棒、珠或钉的髓内植入是治疗长骨慢性骨髓炎广泛应用且被认可的治疗方式。但有时由于髓腔变窄,插入和取出这些抗生素输送系统会变得困难。在此,我们介绍一种制备直径范围为6毫米至3毫米的PMMA棒的技术。这些棒可以很容易地放置在患有慢性骨髓炎或感染性骨不连的长骨狭窄髓腔内。我们使用高粘度骨水泥(Simplex P)以及两种抗生素(头孢呋辛和万古霉素)来制备骨水泥棒。髓内钉固定术中使用的食品级吸管和低调聚四氟乙烯管导丝交换器用作模具。伊里扎洛夫钢丝、1毫米克氏针和24号不锈钢丝用作内部支撑芯材以增强强度。我们将该技术应用于7例患者,成功治疗了上肢和下肢(股骨)长骨感染。平均随访7.28个月,我们系列病例的骨愈合率为71%(5例)。4例(57%)无感染迹象,2例(29%)感染得到控制,1例(14%)仍有感染但实现了骨愈合。