Gao Le-Cai, Chen Jia-Nan, Li Mu-Gang, Li Fu-Bin
Department of Orthopaedics, Hebei Cangzhou Hospital of Integrated Traditional Chinese Medicine and Western Medicine, 5 Xianghai Road, Yunhe District, Cangzhou, 061000, Hebei Province, China.
Department of Orthopaedics, Qinhuangdao Worker's Hospital, Qinhuangdao, 066299, Hebei Province, China.
Sci Rep. 2025 May 16;15(1):16992. doi: 10.1038/s41598-025-00934-2.
Postoperative infections are a significant challenge in orthopedic surgeries, particularly after procedures involving femoral shaft fractures treated with intramedullary nailing. Antibiotic-impregnated bone cement (AIBC) offers a promising solution by providing targeted antimicrobial delivery to the surgical site, potentially enhancing infection control and bone healing. A retrospective analysis was conducted from January 2020 to January 2023, involving 40 patients who developed postoperative infections after femoral shaft fracture treatment with intramedullary nailing. All patients underwent surgical debridement, removal of the original intramedullary nail, reaming of the medullary canal, and implantation of antibiotic-impregnated bone cement rods tailored with vancomycin. Patients were followed for 12 months to assess infection recurrence, bone healing, changes in inflammatory markers (white blood cell count, erythrocyte sedimentation rate, C-reactive protein, and procalcitonin), and functional outcomes including lower limb motor function and daily living activities. All 40 patients showed no signs of infection recurrence, achieving a 100% success rate in managing postoperative infections. Radiological assessments confirmed complete osseous union in all cases. Inflammatory markers significantly decreased post-surgery, indicating effective inflammation control. Significant improvements were also noted in motor functions and daily living activities, as measured by the Fugl-Meyer Assessment and the Activities of Daily Living scales. The use of antibiotic-impregnated bone cement in the treatment of postoperative infections following femoral shaft fracture treatment with intramedullary nailing is highly effective. AIBC not only prevents infection recurrence but also supports robust bone healing and functional recovery. This treatment approach holds promise for broader application in orthopedic surgery.
术后感染是骨科手术中的一项重大挑战，尤其是在采用髓内钉治疗股骨干骨折的手术后。抗生素骨水泥（AIBC）通过向手术部位提供靶向抗菌药物，为解决这一问题提供了一种有前景的方案，有可能增强感染控制和促进骨愈合。对2020年1月至2023年1月期间40例股骨干骨折髓内钉治疗后发生术后感染的患者进行了回顾性分析。所有患者均接受了手术清创、取出原髓内钉、扩髓以及植入用万古霉素定制的抗生素骨水泥棒。对患者进行了12个月的随访，以评估感染复发情况、骨愈合情况、炎症标志物（白细胞计数、红细胞沉降率、C反应蛋白和降钙素原）的变化以及包括下肢运动功能和日常生活活动在内的功能结局。所有40例患者均未出现感染复发迹象，术后感染管理成功率达到100%。影像学评估证实所有病例均实现了完全骨愈合。术后炎症标志物显著下降，表明炎症得到有效控制。通过Fugl-Meyer评估量表和日常生活活动量表测量，运动功能和日常生活活动也有显著改善。在股骨干骨折髓内钉治疗后使用抗生素骨水泥治疗术后感染非常有效。AIBC不仅可预防感染复发，还能促进强劲的骨愈合和功能恢复。这种治疗方法有望在骨科手术中得到更广泛的应用。
