USE OF ANTIBIOTIC CEMENT-COATED NAILS IN MANAGEMENT OF FRACTURE-RELATED INFECTION OF LONG BONES OF THE LOWER LIMB: A CASE REPORT AND LITERATURE REVIEW

Thanh Nha Pham1,, Huy Toan Nguyen2
1 Hospital for Traumatology and Orthopaedics
2 University of Medicine and Pharmacy at Ho Chi Minh City

Main Article Content

Abstract

Antibiotic cement-coated nails have been used to treat fracture-related infection for a long time. The 2018 International Consensus Meeting on Musculoskeletal Infection agreed that antibiotic cement-coated nail were an effective treatment for long bone infections. However, there is no general consensus or specific guideline on the particular techniques used for antibiotic cementcoated nails. We used antibiotic cement-coated nails to treat three cases of  fracture-related infection in long bones of the lower limb. Our technique is based on studies in the literature combined with the availability of devices at our hospital. All three cases achieved good results in eradicating infection, achieving bone healing, allowing for early weight bearing, and decreasing the number of surgeries.

Article Details

References

1. Metsemakers W.J., Morgenstern M., Senneville E., Borens O., Govaert G.A.M., Onsea J., Depypere M., Richards R.G., Trampuz A., Verhofstad M.H.J., Kates S.L., Raschke M., McNally M.A., Obremskey W.T., Fracture-Related Infection (FRI) group. General treatment principles for fracture-related infection: recommendations from an international expert group. Arch Orthop Trauma Surg. 2020.140(8),1013-1027, doi: 10.1007/s00402-019-03287-4.
2. Ismat A., Walter N., Baertl S. Antibiotic cement coating in orthopedic surgery: a systematic review of reported clinical techniques. J Orthop Traumatol. 2021.22(56), https://doi.org/10.1186/s10195-021-00614-7.
3. Kalbas Y., Klingebiel F., Pape H.C. Antibiotic coated nails: Rationale, development, indications and outcomes. J Orthop Surg (Hong Kong). 2022.30(3), doi: 10.1177/10225536221118521.
4. Graff C., Mathur T. Antibiotic impregnated cement coated intramedullary nail (ACCIN) using bronchoscopy tubing: technical tips, case series and a review of the literature. Eur J Orthop Surg Traumatol. 2023, https://doi.org/10.1007/s00590-023-03668-x.
5. Barger J., Fragomen A.T., Rozbruch S.R. Antibiotic-Coated Interlocking Intramedullary Nail for the Treatment of Long-Bone Osteomyelitis. JBJS Rev. 2017.5(7), doi: 10.2106/JBJS.RVW.16.00095.
6. Conway J.D., Elhessy A.H., Galiboglu S., Patel N., Gesheff M.G. Efficacy of Infection Eradication in Antibiotic Cement-Coated Intramedullary Nails for Fracture-Related Infections, Nonunions, and Fusions. Antibiotics (Basel). 2022.11(6):709, doi: 10.3390/antibiotics11060709.