Application of antibiotic cement-coated locking plates in induced membrane technique for treating post-traumatic tibial osteomyelitis
10.3760/cma.j.issn.1001-8050.2017.06.012
- VernacularTitle:抗生素骨水泥被覆锁定钢板在膜诱导技术治疗胫骨创伤后骨感染中的运用
- Author:
Xin YU
;
Shuo JIA
;
Hongri WU
;
Shengpeng YU
;
Zhao XIE
- Keywords:
Osteomyelitis;
Fracture fixation;
internal;
Induced membrane technique
- From:
Chinese Journal of Trauma
2017;33(6):539-543
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the clinical outcome of post-traumatic tibial osteomyelitis treated by induced membrane technique combined with the antibiotic cement-coated locking plate.Methods A restrospective case series analysis was made on 71 cases of post-traumatic tibial osteomyelitis treated by induced membrane technique from September 2014 to September 2014.There were 55 males and 16 females, aged 18-60 years(mean, 37.4 years).Mean length of bone defect following debridement was 4.5 cm(range, 4-11 cm).Antibiotic cement-coated locking plates were used to provide the stability of the bone defects after one-stage debridement.Bone grafting and exchanging the plates with ntramedullary nails were done during the second-stage surgery.Parameters were monitored dynamically after operation to evaluate infection recurrence and bone healing, including C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), clinical features(sinus formation, redness and swelling, warmth and pain) and X-ray films of the involved limbs.Results All patients were followed up for 13-25 months (mean, 19.5 months).There was no sign of recurring infection and CRP and ESR were normal in all cases after the first stage surgery.However, four cases (6%) had recurrent infection with sinus exudates and their CRP and ESR were abnormal after the second stage surgery, and further treatments were carried out on these patients.Follow-up showed bony union in all patients within mean 5.5 months (range, 4-6 months).Conclusion Induced membrane technique with antibiotic cement-coated locking plates for treatment of post-traumatic tibial osteomyelitis can shorten bone healing time and decrease infection recurrent rate without obvious impact on osteogenic activity.
