Sanz-Ruiz Pablo, Calvo-Haro Jose Antonio, Villanueva-Martinez Manuel, Matas-Diez Jose Antonio, Vaquero-Martín Javier
Department of Traumatology and Orthopaedic Surgery, General University Hospital Gregorio Marañón, Madrid, Spain.
Department of Surgery, School of Medicine, Medicine Faculty, Universidad Complutense of Madrid, Spain.
Arthroplast Today. 2017 Mar 31;4(1):58-64. doi: 10.1016/j.artd.2017.02.007. eCollection 2018 Mar.
Bone cement spacers loaded with antibiotic are the gold standard in septic revision. However, the management of massive bone defects constitutes a surgical challenge, requiring the use of different nails, expensive long stems, or cement-coated tumor prostheses for preparing the spacer. In most cases, the knee joint must be sacrificed. We describe a novel technique for preparing a biarticular total femur spacer with the help of a trochanteric nail coated with antibiotic loaded cement, allowing mobility of the hip and knee joints and assisted partial loading until second step surgery. This technique is helpful to maintain the length of the leg, prevent soft tissue contracture, and help eradicate the infection preserving the patient comfort and autonomy while waiting to receive total femoral replacement.
加载抗生素的骨水泥间隔物是感染性翻修手术的金标准。然而，大块骨缺损的处理是一项手术挑战，需要使用不同的髓内钉、昂贵的长柄假体或骨水泥涂层肿瘤假体来制备间隔物。在大多数情况下，膝关节必须被牺牲。我们描述了一种借助涂有载抗生素骨水泥的转子髓内钉制备双关节全股骨间隔物的新技术，该技术可使髋关节和膝关节活动，并在二期手术前辅助部分负重。该技术有助于保持下肢长度，防止软组织挛缩，并有助于根除感染，在等待接受全股骨置换时保持患者的舒适度和自主性。
