Department of Orthopaedics, Apex Trauma Center, SGPGI, Lucknow, Uttar Pradesh, India.
Ann Afr Med. 2023 Oct-Dec;22(4):434-439. doi: 10.4103/aam.aam_185_22.
Chronic osteomyelitis (Chr OM) may result as a sequel of acute hematogenous infection or following open fractures or orthopedic surgeries. Among various osteoarticular infections, Chr OM is one of the most challenging in terms of treatment. In the present study, we evaluate the outcome of antibiotic cement-coated nails in the treatment of chronic pyogenic osteomyelitis and also discuss the future innovations in field of antibiotic-compatible biomaterials for coating the implants.
Twelve cases of Chr OM (5 hematogenous and 7 exogenous following trauma or surgery) were operated by intramedullary nail coated with antibiotic-impregnated bone cement from September 2018 to January 2021. All the cases had bacteriological confirmation of infection by deep curettage and its subsequent culture sensitivity. K nail was used in 10 cases and elastic stable intramedullary nails were used in 2 cases.
Out of 12 cases, 8 were male and 4 were female. The average duration of follow-up was 13 months. Infection was controlled in all the cases (two cases required repeat antibiotic-coated nailing), and there was no incidence of relapse in any case. The control of infection was assessed by clinical assessment and laboratory parameters.
Antibiotic cement-coated nails are an effective method in local control of infection in Chr OM without any systemic side effect.
慢性骨髓炎（Chr OM）可能是急性血源性感染的后遗症，也可能是开放性骨折或骨科手术后的结果。在各种骨关节炎感染中，Chr OM 是治疗最具挑战性的感染之一。在本研究中，我们评估了抗生素骨水泥涂层钉在治疗慢性化脓性骨髓炎中的疗效，并讨论了在可兼容抗生素的生物材料领域为涂层植入物的未来创新。
2018 年 9 月至 2021 年 1 月，我们对 12 例 Chr OM 患者（5 例血源性，7 例继发于创伤或手术后）进行了手术治疗，采用抗生素骨水泥涂层髓内钉。所有病例均通过深部刮除术及随后的培养药敏试验证实有感染。其中 10 例使用 K 钉，2 例使用弹性稳定髓内钉。
12 例患者中，男性 8 例，女性 4 例。平均随访时间为 13 个月。所有病例的感染均得到控制（2 例需要重复抗生素涂层钉治疗），无病例复发。感染的控制通过临床评估和实验室参数进行评估。
抗生素骨水泥涂层钉是 Chr OM 局部控制感染的有效方法，无任何全身副作用。
