Reaming after distal tibia cortical fenestration combined with antibiotic-loaded calcium sulphate for treatment of chronic tibial osteomyelitis after intramedullary nail fixation
10.3760/cma.j.cn115530-20210915-00413
- VernacularTitle:胫骨远端皮质开窗后扩髓结合载抗生素硫酸钙治疗胫骨髓内钉固定术后慢性骨髓炎的疗效分析
- Author:
Yibo XU
1
;
Teng MA
;
Cheng REN
;
Ming LI
;
Yao LU
;
Liang SUN
;
Qiang HUANG
;
Qian WANG
;
Hanzhong XUE
;
Zhong LI
;
Kun ZHANG
Author Information
1. 西安交通大学附属红会医院创伤骨科下肢病区，西安 710054
- Keywords:
Tibia;
Fracture fixation, internal;
Intramedullary;
Osteomyelitis;
Reaming;
Calcium sulphate
- From:
Chinese Journal of Orthopaedic Trauma
2022;24(10):884-891
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To compare the early clinical efficacy between reaming after distal tibia cortical fenestration combined with antibiotic-loaded calcium sulphate and trench grooving combined with polymethyl methacrylate (PMMA) for the treatment of chronic tibial osteomyelitis after intramedullary nail fixation.Methods:A retrospective analysis was conducted in the 20 patients who had been surgically treated for chronic tibial osteomyelitis after intramedullary nail fixation at Department of Trauma Orthopaedics, Honghui Hospital from January 2019 to January 2021. According to the surgical methods, they were divided into a reaming group and a grooving group. In the reaming group, there were 6 males and 3 females with an age of (47.6±11.4) years; in the grooving group, there were 9 males and 2 females with an age of (49.2±13.9) years. The 2 groups were compared in terms of duration of infection, operation time, intraoperative blood loss, bacterial culture results, total hospital stay, time for inflammatory indexes to return to normal, time for weight-bearing, complication rate, infection control rate, and good to excellent rate by Johner-Wruhs joint function scoring.Results:There was no significant difference in the preoperative general data between the 2 groups, showing they were comparable ( P > 0.05). All patients were followed up for 12 to 25 months after operation. There were no significant differences in the duration of infection, operation time, intraoperative blood loss, bacterial culture results, time for inflammatory indexes to return to normal, complication rate, infection control rate, or Johner-Wruhs scoring between the 2 groups ( P > 0.05). The total hospital stay [(11.7 ± 4.7) d] and weight-bearing time [(5.8 ± 1.6) weeks] for the reaming group were significantly shorter than those for the grooving group [(16.8 ± 4.6) d and (8.1 ± 2.9) weeks] ( P < 0.05). Conclusion:In the treatment of chronic tibial osteomyelitis after intramedullary nail fixation, compared with conventional trench grooving combined with PMMA, reaming after distal tibia cortical fenestration combined with antibiotic-loaded calcium sulphate can not only obtain satisfactory outcomes by infection control but also shorten the treatment cycle by allowing the patients to start early weight bearing.
