Treatment of infection related to lower long bone fracture in adults
10.3760/cma.j.cn115530-20230419-00196
- VernacularTitle:成人下肢长骨骨折相关感染的治疗分析
- Author:
Xiaobin CHEN
1
;
Daojing QIU
;
Yuanming HE
;
Yiyun LIN
;
Zhi LIU
Author Information
1. 首都医科大学附属北京同仁医院骨科，北京 100176
- Keywords:
Bones of lower extremity;
Fractures, bone;
Infection;
Masqulet technique;
Bone transfer technique
- From:
Chinese Journal of Orthopaedic Trauma
2023;25(9):819-823
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To introduce our experience in the treatment of infection related to lower long bone fracture in adults.Methods:From January 2017 to December 2020, 31 adult patients with infection related to lower long bone fracture were treated at Department of Orthopaedics, the 7th Medical Center, General Hospital of the People's Liberation Army. They were 20 males and 11 females with an age of (35.7±16.7) years. There were 9 cases of acute infection, 3 cases of delayed infection and 19 cases of late infection. They were treated according to their stage of infection, respectively, by retaining or removing the internal fixation, debridement, bone grafting and bone lengthening. They were followed up regularly for at least 12 months to observe their symptoms, signs, indexes of imaging and blood tests. Paley score for fracture union was recorded at the last follow-up.Results:All the 31 patients were followed up for 13.0(13.0, 31.0) months. Of the 9 patients with acute infection, 6 retained the implant, 1 removed the implant for dressing change due to intolerability and 2 removed the implant due to unsatisfactory infection control. Of the 3 patients with delayed infection, 1 retained the implant and 2 removed the implant because of unsatisfactory infection control. Of the 19 patients with delayed infection, 5 were treated with local bone graft, 6 with Masqulet technique and 8 with bone transfer following debridement and implant removal. All patients were cured without recurrence of infection. According to Paley's scoring, 25 cases were excellent, 5 were good, and 1 was fair.Conclusions:Treatment of infection related to lower long bone fracture in adults should be carried out according to its clinical stage. For acute and delayed infection, implants should be preserved as much as possible; for chronic infection, implants should be removed to perform bone and soft tissue reconstruction after thorough debridement. Personalized diagnosis and treatment protocols can lead to satisfactory clinical results.
