Outcomes of Various Antibiotic Cement Coated Intramedullary Implants on the Treatment of Long Bone Septic Nonunion

2021 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
Luke A. Lopas ◽  
Spencer Albertson ◽  
Eric Solomon ◽  
David T. Watson ◽  
Anjan R. Shah ◽  
...  
Keyword(s):  
Long Bone ◽  
Antibiotic Cement ◽  
Intramedullary Implants

scholarly journals Custom-Made Antibiotic Cement Nails in Orthopaedic Trauma: Review of Outcomes, New Approaches, and Perspectives

2015 ◽  
Vol 2015 ◽  
pp. 1-12 ◽  
Author(s):  
Marcin K. Wasko ◽  
Rafal Kaminski
Keyword(s):  
Failure Mechanisms ◽  
Medullary Canal ◽  
Bone Infection ◽  
Long Bone ◽  
Current Evidence ◽  
Orthopaedic Trauma ◽  
Antibiotic Cement ◽  
Custom Made ◽  
Trauma Surgeons ◽  
Technique Failure

Since the first description in 2002 by Paley and Herzenberg, antibiotic bone cement nails (ACNs) have become an effective tool in the orthopaedic trauma surgeons’ hands. They simultaneously elute high amounts of antibiotics into medullary canal dead space and provide limited stability to the debrided long bone. In this paper, we perform a systematic review of current evidence on ACNs in orthopaedic trauma and provide an up-to-date review of the indications, operative technique, failure mechanisms, complications, outcomes, and outlooks for the ACNs use in long bone infection.

Antibiotic cement-coated Unreamed nailing for Treatment of Infected Nonunion of Long bone

2000 ◽  
Vol 35 (5) ◽  
pp. 699 ◽  
Author(s):  
Suk Ku Han ◽  
Nam Yong Choi ◽  
Seong Jin Park ◽  
Seong Keun Lee ◽  
Gun Jang ◽  
...  
Keyword(s):  
Long Bone ◽  
Infected Nonunion ◽  
Antibiotic Cement ◽  
Unreamed Nailing

Fibular Nail Fixation: Topical Review

2019 ◽  
Vol 40 (11) ◽  
pp. 1331-1337 ◽  
Author(s):  
Henrik C. Bäcker ◽  
J. Turner Vosseller
Keyword(s):  
Bone Fractures ◽  
Clinical Results ◽  
Long Bone ◽  
Implant Design ◽  
Complication Rates ◽  
Level Of Evidence ◽  
Fracture Stabilization ◽  
Fibular Fracture ◽  
Level Ii ◽  
Intramedullary Implants

Background: Intramedullary implants have been used historically in long bone fractures with success. In recent years, a variety of intramedullary implants for the treatment of fibular fractures have been investigated. These various implants have not been assessed together in a cohesive manner. In this review, we assess implants used for intramedullary fixation of fibular fractures with respect to implant design and clinical results. Methods: A comprehensive systematic literature review for intramedullary implants in fibular fractures was performed. All publications that assessed intramedullary fibular implants were reviewed. In total, 11 different intramedullary nails were found. Clinical results obtained from these studies were reviewed. Results: The intramedullary implants used for fibular fracture fixation generally fell into one of 3 categories: an unlocked longitudinal strut, an implant roughly equivalent to a large screw, or a more traditionally locked intramedullary nail. Reported clinical results were generally good, although inconsistent outcome reporting greatly limited comparison between studies. Complication rates varied with the implants but were generally low. Conclusion: Intramedullary implants for fibular fracture stabilization have changed over the years to improve stability. Although clinical results are limited, data suggest that these implants are safe and can potentially approximate more traditional implants. Level of Evidence: Level II, systematic review.

scholarly journals Use of antibiotic cement-impregnated intramedullary nail in treatment of infected non-union of long bone

2009 ◽  
Vol 43 (4) ◽  
pp. 396 ◽  
Author(s):  
ParagK Sancheti ◽  
SalimK Patel ◽  
Steve Rocha ◽  
AshokK Shyam
Keyword(s):  
Intramedullary Nail ◽  
Long Bone ◽  
Non Union ◽  
Antibiotic Cement

↵​Efficacy of Multi-ion Doped Plasma Spray Nano-hydroxyapatite Coated Titanium Implants in Long Bone Fracture Repair in Dogs- Radiographical and Bone Markers Evaluation

2021 ◽  
Author(s):  
G. Vani ◽  
P. Veena ◽  
R.V. Suresh Kumar ◽  
M. Santhi Lashmi ◽  
D. Rani Prameela ◽  
...  
Keyword(s):  
Plasma Spray ◽  
Bone Fracture ◽  
Bone Markers ◽  
Fracture Site ◽  
Fracture Repair ◽  
Titanium Implants ◽  
Long Bone ◽  
Tissue Remodelling ◽  
Long Bone Fracture ◽  
Intramedullary Implants

Background: Fracture of long bones is a common orthopaedic condition noticed in dogs and its primary goal is to completely restore the function of the injured limb as early as possible. Osteo-conductivity of hydroxyapatite can be improved further by decreasing the particle size to nanometre range and incorporation of inorganic materials in hydroxyapatite can enhance osteoblast cell material interactions. Strontium, Zinc, Silver and Fluorine are known to play an important role in the bone formation and also affect bone material characteristics such as crystallinity, degradation behaviour and mechanical properties. When doped with plasma spray nanohydroxyapatite, these multi-ions cause no harm to the physical environment during the degradation process of hydroxyapatite as these are nontoxic and play significant role in bone metabolism, growth and nourishment. Bone markers have tremendous potential as a rapid and sensitive method for assessing the response of the skeleton to medical or surgical interventions providing valuable information regarding bone turn over in animals. Hence, the current study was undertaken to evaluate the potential of multi-ion doped nano-hydroxyapatite coated intramedullary titanium implants in long bone fracture repair in dogs compared to the conventional intramedullary titanium implants through radiographical studies and evaluation of bone markers. Methods: Radiographical evaluation, Sandwich ELISA kits developed by Bioassay technology laboratory. Result: Plasma spray nano-hydroxyapatite coated titanium intramedullary implants have shown excellent osteo-conductivity when doped with multi-ions of Strontium, Zinc, Silver and Fluorine facilitating rapid osteoblastic activity and rapid bone turnover at the fracture site and complete fracture healing by 3rd week post-operatively as evidenced by radiographic scores and a peak BALP (Canine Bone Alkaline Phosphatase) values and early limb usage. Bone reabsorption and bone tissue remodelling due to osteoclastic action at the fracture site was quicker when the multi-ion doped nano-hydroxyapatite coated titanium intramedullary implants were used which is evidenced by the radiographic scores and highest CTX (Canine C-telopeptide of Type 1 Collagen) values indicating completion of fracture healing and near completion of bone tissue remodelling by 9th post-operative week in long bone fracture repair in dogs.

scholarly journals Custom-Made Antibiotic Cement-Coated Nail for the Treatment of Infected Bone Defect

2021 ◽  
Vol 2021 ◽  
pp. 1-12
Author(s):  
Guoliang Wang ◽  
Wen Luo ◽  
Yong Zhou ◽  
Zhenfeng Zhu ◽  
Zihou Zhao ◽  
...  
Keyword(s):  
Infection Control ◽  
Bone Healing ◽  
Bone Defects ◽  
Long Bone ◽  
Antibiotic Cement ◽  
Sf 36 ◽  
Custom Made ◽  
Printing Technique ◽  
3D Printing Technique

Background. Longbone infected bone defect remains a great challenge due to multiple surgeries, long-term treatment duration, and uncertain prognosis. Treatment principles include eradication/debridement, stabilization, and antibiotic administration. An antibiotic cement-coated nail has shown great prospects due to both local antibiotic elution and stabilization of bone defects. However, the current fabrication technique remains to be improved. Methods. For the first time, we described a new method for custom-made cement-coated nail fabrication based on a 3D printing technique. A retrospective study of 19 consecutive patients with long bone infected bone defects from one medical center was conducted who met the inclusion and exclusion criteria from November 2016 to May 2020. The treatment involved thorough debridement, custom-made antibiotic cement-coated nail filling, and culture-specific systemic antibiotic treatment guided by a multidisciplinary team. Clinical and radiographic examinations (X-ray and CT scans) were used to evaluate bony union. Clinical and laboratory examinations were used to evaluate the infection control. The SF-36 score was used to evaluate patients’ quality of life pre- and postoperatively. Results. The mean follow-up was 98.8 weeks (ranging from 40 to 192). All cases achieved infection control, 3 cases achieved bone healing after one-stage operation, and 12 cases achieved bone healing after a two-stage bone graft procedure. At the last follow-up, none of the 19 patients had infection recurrence or 1 case had failure of the protective plate. The pre- and postoperative SF-36 score showed that there were statistical differences in all the 9 aspects. Conclusions. The precise custom-made antibiotic cement-coated intramedullary nail through the 3D printing technique used in this study is an effective strategy for the treatment of infected bone defects of long bone. This technique may help to increase the infection control rate and promote bone healing.

scholarly journals The experience of use the bioactive coated intramedullary flexible nailiing in treatment of long bone fracture

2021 ◽  
Vol 3 (2) ◽  
pp. 40-47
Author(s):  
Arnold V. Popkov ◽  
Dmitriy A. Popkov ◽  
Konstantin V. Trofimov ◽  
Alexander I. Nikiforov ◽  
Alexey А. Isupov
Keyword(s):  
Bone Formation ◽  
Bone Fracture ◽  
Fracture Zone ◽  
Bone Fractures ◽  
Lower Limbs ◽  
Long Bone ◽  
Long Bone Fracture ◽  
Formation Dynamics ◽  
Diaphyseal Fractures ◽  
Intramedullary Implants

The study concerns a new method of treatment of bone fractures of upper and lower limbs based on osteogenesis stimulation by intramedullary implants with bioactive organic hydroxyapatite (HA). The method decreases consolidation period of diaphyseal fractures to 2-4 times. A technology of osteosynthesis and bone formation dynamics at the fracture zone and around the implant is described.

scholarly journals Two stage management of long bone infection by using an antibiotic cement-coated locking plate: an outcome of 183 cases

2019 ◽  
Author(s):  
Chao Jia ◽  
Xiaohua Wang ◽  
Shengpeng Yu ◽  
Hongri Wu ◽  
Jie Shen ◽  
...  
Keyword(s):  
Infection Control ◽  
Internal Fixation ◽  
Bone Grafting ◽  
Clinical Effect ◽  
Locking Plate ◽  
Lower Extremities ◽  
Bone Infection ◽  
Long Bone ◽  
Antibiotic Cement

Abstract Background The purpose of this study was to evaluate the clinical effect of antibiotic cement-coated locking plate as temporary internal fixation for the treatment of long bone infection in lower extremities . Methods Retrospective analysis the clinical data of 183 patients with lower extremities long bone infection admitted to our hospital from January 2013 to December 2017. All patients were treated with locking plate internal fixation after primary debridement. Antibiotic cement was used to fill the bone defect and wrap the plate. After infection control, bone grafting to reconstruct the bone defect. Results There were 81 cases of femur, 100 cases of tibia and 2 cases of fibula, after the first stage, 16(8.7%) patients had recurrence of infection after the first stage which have to debridement again. 4 tibial infecton patients had poor wound healing, 2 femoral patients had fixation failure, and 1 patient had femoral fracture due to fall down. After a mean time of 32.0 months (range 12 to 66) follow up, the recurrence rate of infection was 14.2% (26/183). Among them, eighteen patients underwent bone grafting after re-debridement, 6 patients received permanent placement of antibiotic bone cement after debridement, and 2 patients refused further treatment and chose amputation. Bone healing was achieved in 175(95.9%) patients in the last follow-up, and the average time of bone union was 5.4 months (range 4 to 12 months). Conclusions Temporary internal fixation with antibiotic cement coated locking plate has good clinical effect in the treatment of lower extremities long bone infection. It does not increase the difficulty of bone infection control. Pay attention to possible difficulty of skin coverage when applied in calves. Key words: Antibiotic cement coated locking plate, Bone infection, Internal fixation

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