Custom-made antibiotic cement nails: A comparative study of different fabrication techniques

Kim, Ji Wan; Cuellar, Derly O.; Hao, Jiandong; Seligson, David; Mauffrey, Cyril

doi:10.1016/j.injury.2014.03.006

Cited by 43 publications

(39 citation statements)

References 19 publications

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“…Gentamicin has been the most widely used agent followed by vancomycin 19,20 . In our study, we used the combination of vancomycin with teicoplanin as both have the desired properties.…”

Section: Introductionmentioning

confidence: 99%

Role of Antibiotic Cement Coated Nailing in Infected Nonunion of Tibia

Bhatia

Sharma

et al. 2017

MOJ

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IntroductionInfected nonunion of long bones is a chronic and debilitating disorder. It is more difficult to deal with when the implant used for internal fixation itself becomes a potential media for infection because of bacterial adhesion and biofilm formation. Traditionally, it is managed by two-stage procedure for controlling the infection first and then treating the nonunion. This study has been undertaken to explore antibiotic cement coated nailing as single stage treatment modality for treating infection and achieving stability at the same time.Materials and MethodsTwenty patients (above 18 years of age) with infected nonunion of tibia with bone gap less than 2 cm were managed using antibiotic cement coated K-nail. Antibiotic cement nail was prepared using endotracheal tube method. Antibiotics used were a combination of vancomycin and teicoplanin.ResultsInfection was controlled in 95% of the patients. Bony union was achieved in 12 of 20 (60%) patients with antibiotic cement nailing as the only procedure with average time of union of 32 weeks. Remaining 8 patients required additional procedures like bone grafting or exchange nailing and these were done in six patients, with union of fracture. Two patients refused to undergo further procedures. Complications encountered were difficult nail removal in three cases, broken nail in two cases, and bent nail in one case. Recurrence of infection was observed in two patients. Average period of follow-up was 13 months.ConclusionAntibiotic cement impregnated nailing is a simple, economical and effective single stage procedure for the management of infected nonunion of tibia. It is advantageous over external fixators, as it eliminates the complications of external fixators and has good patient compliance. The method utilizes existing easily available instrumentation and materials and is technically less demanding, and therefore can be performed at any general orthopaedic center.

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“…Gentamicin has been the most widely used agent followed by vancomycin 19,20 . In our study, we used the combination of vancomycin with teicoplanin as both have the desired properties.…”

Section: Introductionmentioning

confidence: 99%

Role of Antibiotic Cement Coated Nailing in Infected Nonunion of Tibia

Bhatia

Sharma

et al. 2017

MOJ

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“…Multiple techniques for the fabrication of the nails have been described, from manual rolling of the cement [ 34 ], through the use of chest tube as a temporary mould, which is peeled off once the cement hardens [ 12 , 21 , 23 , 29 , 35 , 37 , 38 , 44 ], to using a reusable mould [ 45 , 46 ].…”

Section: Resultsmentioning

confidence: 99%

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

Waśko¹,

Kaminski²

2015

BioMed Research International

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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.

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“…Additionally, no definitive evidence is present which attributes the eradication of infection and the creation of bony union to our antibiotic nail construct as opposed to it being a result of systemic antibiotics and replacement of an intramedullary implant. Our technique could be improved by cooling the curing cement in a cold sterile water basin to minimize melting of the chest tube and subsequent increased difficulty and time to prepare the final implant [25].…”

Section: Discussionmentioning

confidence: 99%

Antibiotic Intramedullary Nail in the Management of Infected Ununited Tibial Fractures - Case Report, Technique and Review of Literature

McMurtry¹

2016

CSMC

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Custom-made antibiotic cement nails: A comparative study of different fabrication techniques

Cited by 43 publications

References 19 publications

Role of Antibiotic Cement Coated Nailing in Infected Nonunion of Tibia

Role of Antibiotic Cement Coated Nailing in Infected Nonunion of Tibia

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

Antibiotic Intramedullary Nail in the Management of Infected Ununited Tibial Fractures - Case Report, Technique and Review of Literature

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