Woo Inha, Park Jeongjin, Seok Hyungyu, Kim Tae-gon, Moon Jun Sung, Chung Seung Min, Park Chul Hyun
Department of Orthopedics, Yeungnam University Hospital, Daegu 38541, Korea.
Department of Plastic Surgery, College of Medicine, Yeungnam University, Daegu 38541, Korea.
J Clin Med. 2022 Apr 1;11(7):1976. doi: 10.3390/jcm11071976.
Forefoot osteomyelitis can be an extremely challenging problem in orthopedic surgery. Unlike conventional methods, such as amputations, antibiotic impregnated cement space (ACS) was recently introduced and perceived as a substitute for amputation. The purpose of this study was to compare clinical features between diabetic and non-diabetic groups and to evaluate the efficacy of ACS in the treatment of forefoot osteomyelitis, by identifying the clinical characteristics of ACS. We inserted ACS into the forefoot osteomyelitis patients and regularly checked up on them, then analyzed the clinical features of the patients and failure reasons, if ACS had to be removed. Average survival rate of ACS was 60% (21 out of 35 cases) and main failure reason was recurrence of infection. There was no significant clinical difference between diabetic and non-diabetic groups. We concluded that ACS could be a possible way of avoiding amputation if infection is under control. ACS seems to be an innovative method with promising results for foot osteomyelitis, but widely accepted indications need to be agreed upon.
前足骨髓炎在整形外科手术中可能是一个极具挑战性的问题。与传统方法（如截肢）不同，抗生素浸渍骨水泥间隙（ACS）最近被引入，并被视为截肢的替代方法。本研究的目的是通过确定ACS的临床特征，比较糖尿病组和非糖尿病组之间的临床特征，并评估ACS治疗前足骨髓炎的疗效。我们将ACS植入前足骨髓炎患者体内并定期对他们进行检查，然后分析患者的临床特征以及如果必须取出ACS时的失败原因。ACS的平均存活率为60%（35例中的21例），主要失败原因是感染复发。糖尿病组和非糖尿病组之间在临床上没有显著差异。我们得出结论，如果感染得到控制，ACS可能是避免截肢的一种可行方法。ACS似乎是一种对足部骨髓炎有前景结果的创新方法，但需要就广泛接受的适应症达成共识。
