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.

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 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

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 Mechanical flexural ex vivo study of osteotomized swine femurs stabilized with two types of polyamide 12 rods

2017 ◽  
Vol 47 (8) ◽  
Author(s):  
Juliana Scarpa da Silveira Almeida ◽  
Débora de Oliveira Garcia ◽  
Renato Camargo Bortholin ◽  
Carlos Amaral Razzino ◽  
Cristiane dos Santos Honsho ◽  
...  
Keyword(s):  
Bone Fractures ◽  
Ex Vivo ◽  
Polymeric Materials ◽  
Fracture Site ◽  
Medullary Canal ◽  
Modulus Of Rupture ◽  
Long Bone ◽  
Bone Implant ◽  
Polyamide 12 ◽  
Implant System

ABSTRACT: Long bone fractures are commonly in surgery routine and several bone imobilization techniques are currently available. Technological progress has enabled to use low cost materials in surgical procedures. Thus, the aim of this study was to evaluate the applicability of polyamide 12 rods, solid and hollow in swine femurs, comparing them through flexion strength. This study had as second aim to fix the locking errors, commom place in interlocking nails, once polyamide 12 allows perforation in any direction by orthopaedic screw. Six groups were used: G1 - eight whole swine femurs; G2 - eight whole swine femurs with drilled medullary canal; G3 - two solid polyamide 12 rods; G4 - two hollow polyamide 12 rods; G5 - eight osteotomized drilled swine femurs with a solid polyamide 12 rod implanted in the medullary canal and locked by four 316L stainless steel screws; and G6 - similar to G5 but using hollow rods instead of solid ones. No significant differences were observed for the modulus of rupture between solid and hollow rods, demonstrating that both rods had similar performances. These results led to the speculation that the addition of other polymers to the hollow rods could increase their strength and thus the bone-implant system. Furthermore, the comparison between G1, G5 and G6 could be analyzed using the finite element method in future. New polymeric materials may be developed based on the data from this study, strengthening the bone-implant system and making possible screws to be placed in any direction, nullifying the detrimental forces on the fracture site.

Current Practice in the Management of Open Fractures Among Orthopaedic Trauma Surgeons. Part B

2014 ◽  
Vol 28 (8) ◽  
pp. e203-e207 ◽  
Author(s):  
William Obremskey ◽  
Cesar Molina ◽  
Cory Collinge ◽  
Paul Tornetta ◽  
Claude Sagi ◽  
...  
Keyword(s):  
Current Practice ◽  
Open Fractures ◽  
Orthopaedic Trauma ◽  
Trauma Surgeons

Titanium Elastic Nails for Distal Radius-ulna Fractures in Young Dogs

2021 ◽  
Author(s):  
Harmanpreet Singh Sodhi ◽  
Ashwani Kumar ◽  
Arun Anand ◽  
Vandana Sangwan ◽  
Dhiraj Kumar Gupta
Keyword(s):  
Distal Radius ◽  
Bone Fractures ◽  
Weight Bearing ◽  
Medullary Canal ◽  
Long Term Results ◽  
Long Bone ◽  
Uneventful Recovery ◽  
Fractures In Children ◽  
Ulna Fractures ◽  
Elastic Nails

Background: Radius-ulna is the most frequently fractured bone of the pectoral limb in dogs with high predisposition to distal fractures. The smaller size of the distal fragment and open physis restrict the use of rigid fracture fixation techniques in distal fractures of growing dogs. Titanium elastic nails (TENs) are recommended in medical practice to stabilize long bone fractures in children. There is paucity of literature on TENs for the repair of radius-ulna fractures in dogs. Methods: This clinical study enrolled 10 dogs (7 grey hound and one each of Crossbred, Pomerenarian and Siberian Husky) suffering from distal radius-ulna (6 transverse and 4 short oblique) fractures since a mean ± SD duration of 3.40±4.5 days. The mean ± SD age and body weight of the dogs was 12.60±6.45 months and 14.09±6.41 Kg, respectively. All except one fracture was stabilized with two TENs inserted into the medullary canal of radial bone in a normograde manner from distal to proximal end using open cranio-lateral surgical approach. Result: Majority fractures achieved satisfactory reduction (n=8), radiographically. Weight bearing scores on walking increased gradually from day 12 (1.62 ± 1.51) to 45th (2.57±1.51), day 60th (3.75±0.5) and day 90 (4.0±0). Five dogs had uneventful recovery whereas remaining had major (n=2) or minor (n=3) complications. The length of the operated bone was non-significantly lesser as compared to contralateral healthy bone on day 60. Goniometric assessment of carpal joint of operated limb showed restricted range of motion on day 12 that improved to the near normal as contralateral healthy limb on day 60. Long-term results showed full (9) and acceptable (1) functional outcome. In conclusions, the TENs technique is simple and less invasive alternative fixation technique for distal radius-ulna fractures in young and light weighing dogs. As per authors, this is the first report on the use of TENs for the management of radius-ulna fracture in dogs.

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

Clinical practice in prevention of fracture-related infection: An international survey among 1197 orthopaedic trauma surgeons

Injury ◽  
2019 ◽  
Vol 50 (6) ◽  
pp. 1208-1215 ◽  
Author(s):  
Jan Puetzler ◽  
Charalampos Zalavras ◽  
Thomas F. Moriarty ◽  
Michael H.J. Verhofstad ◽  
Stephen L. Kates ◽  
...  
Keyword(s):  
Clinical Practice ◽  
International Survey ◽  
Orthopaedic Trauma ◽  
Trauma Surgeons

scholarly journals What is the role of ultrasound in fracture management?

2019 ◽  
Vol 8 (7) ◽  
pp. 304-312 ◽  
Author(s):  
J. A. Nicholson ◽  
S. T. J. Tsang ◽  
T. J. MacGillivray ◽  
F. Perks ◽  
A. H. R. W. Simpson
Keyword(s):  
Image Processing ◽  
Fracture Healing ◽  
Bone Fractures ◽  
Therapeutic Ultrasound ◽  
Long Bone ◽  
Future Application ◽  
Current Evidence ◽  
Potential Clinical Benefit ◽  
Fracture Management

Objectives The aim of this study was to review the current evidence and future application for the role of diagnostic and therapeutic ultrasound in fracture management. Methods A review of relevant literature was undertaken, including articles indexed in PubMed with keywords “ultrasound” or “sonography” combined with “diagnosis”, “fracture healing”, “impaired fracture healing”, “nonunion”, “microbiology”, and “fracture-related infection”. Results The use of ultrasound in musculoskeletal medicine has expanded rapidly over the last two decades, but the diagnostic use in fracture management is not routinely practised. Early studies have shown the potential of ultrasound as a valid alternative to radiographs to diagnose common paediatric fractures, to detect occult injuries in adults, and for rapid detection of long bone fractures in the resuscitation setting. Ultrasound has also been shown to be advantageous in the early identification of impaired fracture healing; with the advent of 3D image processing, there is potential for wider adoption. Detection of implant-related infection can be improved by ultrasound mediated sonication of microbiology samples. The use of therapeutic ultrasound to promote union in the management of acute fractures is currently a controversial topic. However, there is strong in vitro evidence that ultrasound can stimulate a biological effect with potential clinical benefit in established nonunions, which supports the need for further investigation. Conclusion Modern ultrasound image processing has the potential to replace traditional imaging modalities in several areas of trauma practice, particularly in the early prediction of impaired fracture healing. Further understanding of the therapeutic application of ultrasound is required to understand and identify the use in promoting fracture healing. Cite this article: J. A. Nicholson, S. T. J. Tsang, T. J. MacGillivray, F. Perks, A. H. R. W. Simpson. What is the role of ultrasound in fracture management? Diagnosis and therapeutic potential for fractures, delayed unions, and fracture-related infection. Bone Joint Res 2019;8:304–312. DOI: 10.1302/2046-3758.87.BJR-2018-0215.R2.

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