Intramedullary application of local antibiotic bullets for the treatment of long bone fracture related infection.
Calcium sulphate
Fracture related infection
Local antibiotics
Long bone fractures
Journal
European journal of orthopaedic surgery & traumatology : orthopedie traumatologie
ISSN: 1432-1068
Titre abrégé: Eur J Orthop Surg Traumatol
Pays: France
ID NLM: 9518037
Informations de publication
Date de publication:
Feb 2023
Feb 2023
Historique:
received:
09
12
2021
accepted:
05
01
2022
pubmed:
14
1
2022
medline:
17
2
2023
entrez:
13
1
2022
Statut:
ppublish
Résumé
The optimal means of local antibiotic delivery for fracture related infection is unknown. Until now, intramedullary application of calcium sulphate based local antibiotics has been challenging. We report on the use of a newly available mode of preparation and delivery: the Stimulan Bullet Mat and Introducer (Biocomposites Ltd, Staffordshire, England). A retrospective analysis of prospectively collected data for infection cases at two separate tertiary referral institutions was performed. We included cases of long bone FRI with a retained intramedullary nail, treated with a single stage protocol of metalwork removal, debridement, local antibiotic application using the novel mould and applicator, with additional bony stabilisation and soft tissue reconstruction where required. All 13 patients achieved infection remission rate with an average follow-up of 19.7 months (range 12-28). All 6 patients with infection around an unhealed fracture achieved union at an average 8 months (range 4-12) from debridement. No patients developed aseptic wound leak. Antibiotic impregnated calcium sulphate can be used safely as part of a single stage treatment protocol for the treatment of long bone fracture related infection following intramedullary nailing. We have demonstrated high rates of infection remission and union, using a newly available intramedullary applicator.
Identifiants
pubmed: 35024952
doi: 10.1007/s00590-022-03205-2
pii: 10.1007/s00590-022-03205-2
doi:
Substances chimiques
Anti-Bacterial Agents
0
Calcium Sulfate
WAT0DDB505
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
385-391Informations de copyright
© 2022. The Author(s), under exclusive licence to Springer-Verlag France SAS, part of Springer Nature.
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