Antibiotic Cement-Coated Interlocked Intramedullary Nails for the Treatment of Infected Nonunion After Intramedullary Nailing. Issue 1 (January 2023)

• Record Type: Journal Article
• Authors: Zalikha, Abdul K.; Sayeed, Zain; Stine, Sasha A.; Bray, Ryan; Vaidya, Rahul
• Is Part Of: Journal of orthopaedic trauma. Volume 37:Issue 1(2023)
• Page Start: e1
• Page End: e6
• Publication Date: 2023-01
• Subjects: antibiotic nails -- intramedullary nailing infection -- intramedullary osteomyelitis -- septic nonunion -- infected nonunion -- fracture-related infection; Orthopedics -- Periodicals; Wounds and injuries -- Periodicals; Orthopedics -- Periodicals; Wounds and Injuries -- therapy -- Periodicals; Periodicals; 617.47044
• DOI: 10.1097/BOT.0000000000002453
• Languages: English
• ISSNs: 0890-5339

Abstract

Abstract : Objective: To evaluate outcomes using an interlocking antibiotic cement-coated nail and culture-specific systematic antibiotics in the treatment of infected nonunion after intramedullary nailing. Design: Retrospective observational cohort study. Setting: Urban level I trauma center. Patients/Participants: Forty-one nonconsecutive patients who presented to a level I trauma center who underwent interlocked antibiotic nailing for treatment of infected nonunion status after primary intramedullary nailing. Outcomes: Eradication of infection, radiographic union by 2-year follow-up. Results: Antibiotic nailing successfully eradicated infection and led to fracture healing in 35 patients (85.4%), while 6 patients (14.6%) had persistent infection and required further surgical treatment. Of the 6 patients who required further treatment, 5 eventually went on to heal with fracture union and eradication of their infection, while 1 required a salvage procedure. Of the 5 patients who eventually went on to heal, 4 of them healed with repeat antibiotic or intramedullary nails, while 1 required segmental resection and bone grafting before healing. Conclusions: This study suggests that the proposed interlocked antibiotic nailing technique is a viable therapeutic option to eradicate infected nonunion and support fracture healing. Level of Evidence: Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.