Hip & pelvis

  • 제30권1호
  • /
  • Pages.45-52
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  • 2018
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  • 2287-3260(pISSN)
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  • 2287-3279(eISSN)
대한고관절학회 (The Korean Hip Society)
권호 표지
DOI QR코드

DOI QR Code

Treatment of Proximal Femur Osteomyelitis Occurred after Proximal Femoral Nail Antirotation Fixation, with Antibiotic Cement-coated Tibia Intramedullary Nail: A Case Report

  • Noh, Jong Ho (Department of Orthopedic Surgery, The Catholic University of Korea, Bucheon St. Mary's Hospital) ;
  • Koh, Sung Jun (Department of Orthopedic Surgery, The Catholic University of Korea, Bucheon St. Mary's Hospital) ;
  • Lee, Kee Haeng (Department of Orthopedic Surgery, The Catholic University of Korea, Bucheon St. Mary's Hospital)
  • 투고 : 2017.06.26
  • 심사 : 2017.12.11
  • 발행 : 2018.03.01
⟨ 이전 논문 다음 논문 ⟩

초록

Antibiotic cement-coated intramedullary nails maintain a locally high antibiotic concentration while contributing to bone stability. We present a case of femoral subtrochanteric fracture in a patient with an infected nonunion who was successfully treated for an infection and nonunion using an antibiotic cement-coated tibial intramedullary nail. A 79-year-old woman with a right femoral subtrochanteric fracture underwent internal fixation using proximal femoral nail antirotation (PFNA). She developed osteomyelitis with nonunion at the surgical site 10 months postoperatively. We decided to insert an antibiotic cement-coated tibial intramedullary nail. After coating the nail with bone cement mixed with antibiotics, bone fixation was achieved by inserting the nail at the site of the PFNA. The patient's symptoms improved, symptoms from the infection disappeared, and bone union was confirmed. Osteomyelitis occurred because of postoperative infection following a proximal femoral fracture. Antibiotic cement-coated tibial intramedullary nails are an effective option to treat patients with osteomyelitis of the femur and achieve bone union where nonunion persists with shallow a intramedullary femoral canal.

키워드

참고문헌

  1. Patzakis MJ, Zalavras CG. Chronic posttraumatic osteomyelitis and infected nonunion of the tibia: current management concepts. J Am Acad Orthop Surg. 2005;13:417-27. https://doi.org/10.5435/00124635-200510000-00006
  2. Zalavras CG, Patzakis MJ, Holtom P. Local antibiotic therapy in the treatment of open fractures and osteomyelitis. Clin Orthop Relat Res. 2004;(427):86-93.
  3. Beals RK, Bryant RE. The treatment of chronic open osteomyelitis of the tibia in adults. Clin Orthop Relat Res. 2005;(433):212-7.
  4. Thonse R, Conway J. Antibiotic cement-coated interlocking nail for the treatment of infected nonunions and segmental bone defects. J Orthop Trauma. 2007;21:258-68. https://doi.org/10.1097/BOT.0b013e31803ea9e6
  5. Bharti A, Saroj UK, Kumar V, Kumar S, Omar BJ. A simple method for fashioning an antibiotic impregnated cemented rod for intramedullary placement in infected non-union of long bones. J Clin Orthop Trauma. 2016;7(Suppl 2):171-6. https://doi.org/10.1016/j.jcot.2016.08.004
  6. Struijs PA, Poolman RW, Bhandari M. Infected nonunion of the long bones. J Orthop Trauma. 2007;21:507-11. https://doi.org/10.1097/BOT.0b013e31812e5578
  7. Riel RU, Gladden PB. A simple method for fashioning an antibiotic cement-coated interlocking intramedullary nail. Am J Orthop (Belle Mead NJ). 2010;39:18-21.
  8. Roche O, Zabee L, Sirveaux F, Villanueva E, Mole D. Treatment of septic nonunion of long bones: preliminary results of a two-stage procedure. J Bone Joint Surg Br Proc. 2005;87- B:111-2. https://doi.org/10.1302/0301-620X.87B1.15150
  9. Lew DP, Waldvogel FA. Osteomyelitis. Lancet. 2004;364: 369-79. https://doi.org/10.1016/S0140-6736(04)16727-5
  10. Neut D, van de Belt H, van Horn JR, van der Mei HC, Busscher HJ. The effect of mixing on gentamicin release from polymethylmethacrylate bone cements. Acta Orthop Scand. 2003;74:670-6. https://doi.org/10.1080/00016470310018180

피인용 문헌

  1. Commercially available antibiotic-laden PMMA-covered locking nails for the treatment of fracture-related infections - A retrospective case analysis of 10 cases vol.4, pp.4, 2018, https://doi.org/10.7150/jbji.34072