Evaluation of role of antibiotic cement impregnated intramedullary nail in infected long bone fractures
Abstract
Infected long bone fracture is a debilitating disorder. Traditionally treatment of infected long bone fracture follows the multistage procedure such as debridement and systemic antibiotics with temporary fixation and than permanent fixation and bone grafting when required or bone transport.For the treatment of infected long bone fracture Single staged procedures such as debridement and application of Ilizarov fixator and limb reconstruction system (LRS) are also available but these procedures are technically demanding, need good patients compliance and regular long term follow up.This study was to evaluate the role of antibiotic cement impregnated intramedullary nail (ACIIN) in treatment ofinfected long bone fractures. ACIINs provide a high concentration of antibiotics locally, provide mechanical stability, good infection control, promotes bone union by simple and one stage procedure. We prospectively studied a cohort of 25 culture positive cases with infected long bone fracture with bone defect less then 2 cm (22 tibia and 3 femur), mean age being 35.4 year were treated by ACIINs. Most common organism isolated in culture was staphylococus aureus. Infection control was judged on the basis of discharge through the wound and laboratory parameters at regular follow up. 24 cases achieved infection control and bone union without need of other secondary procedure and only one patient shows poor result that lost to follow up. So we find ACIINs as single stage procedure for controlling infection, providing mechanical stability and there by promoting bone union in infected long bone fracture.
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