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用抗生素骨水泥涂覆钢板治疗骨折内固定术后早期感染并保留植入物:技术说明

Coating the plate with antibiotic cement to treat early infection after fracture fixation with retention of the implants: a technical note.

作者信息

Qiu Xu-Sheng, Cheng Bei, Chen Yi-Xin, Qi Xiao-Yang, Sha Wei-Ping, Chen Guo-Zhao

机构信息

Department of Orthopaedics, Nanjing University Medical School Affiliated Nanjing Drum Tower Hospital, No. 321 Zhongshan Road, Nanjing, China.

Department of Orthopaedics, The First People's Hospital of Zhangjiagang, No. 68 Jiyangxi Road, Zhangjiagang, China.

出版信息

BMC Musculoskelet Disord. 2018 Oct 10;19(1):360. doi: 10.1186/s12891-018-2285-2.

Abstract

BACKGROUND

Local antibiotic therapy has gained increasing attraction in the prevention and treatment of fracture infection. However, no reports have used local antibiotic therapy in the management of early infection after fracture fixation with retention of implants.

METHODS

The present surgical technique report the use of antibiotic impregnated bone cement in the management of early infection after fracture fixation. Initially, the fractures were fixed with plates. The average time from initial procedure to debridement was15 days (range 9 to 25 days). The infections were treated with irrigation, debridement, and retention of the implant. The lateral surface of the plates was coated with antibiotic cement and the bone defect was filled with antibiotic cement spacer after thorough debridement.

RESULTS

Ten patients underwent this technique. The mean follow-up was 2.0 years (range 6 months to 4 years). The bone union rate was 100%, and the average time to bone healing was5.5 months.There was recurrence of infection in one patient before bone healing, but the implants were left in place until bone healed, and the infection was eradicated after implant removal.

CONCLUSION

Coating the plate with antibiotic cement is a simple technique which may play a role in the management of early infection after fracture fixation.

摘要

背景

局部抗生素治疗在骨折感染的预防和治疗中越来越受到关注。然而,尚无关于在保留植入物的骨折固定术后早期感染管理中使用局部抗生素治疗的报道。

方法

本手术技术报告了抗生素浸渍骨水泥在骨折固定术后早期感染管理中的应用。最初,骨折用钢板固定。从初次手术到清创的平均时间为15天(范围9至25天)。感染采用冲洗、清创和保留植入物的方法进行治疗。在彻底清创后,钢板侧面涂覆抗生素骨水泥,骨缺损用抗生素骨水泥间隔物填充。

结果

10例患者接受了该技术治疗。平均随访2.0年(范围6个月至4年)。骨愈合率为100%,平均骨愈合时间为5.5个月。1例患者在骨愈合前感染复发,但植入物保留原位直至骨愈合,植入物取出后感染得以根除。

结论

用抗生素骨水泥涂覆钢板是一种简单的技术,可能在骨折固定术后早期感染的管理中发挥作用。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0677/6178260/30b515dc8e1e/12891_2018_2285_Fig1_HTML.jpg

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