Antibiotic Impregnated Cement Dowel in a Tibial Stump to Salvage Infected Below-Knee Amputation in a Diabetic

Abstract

Case: We describe the use of local antibiotics to salvage an infected below-knee amputation in a diabetic patient and prevent the need to convert to the above-knee level. After débridement, an antibiotic tibial “dowel” was fashioned and inserted into the intramedullary canal before closure. The wound was fully healed after four months, and the patient remained satisfied at 15 months. Conclusion: This case report offers an adjunct to the conventional management of diabetic stump infections. The addition of an antibiotic spacer could offer an alternative to a higher level of amputation and improve the survival rates of below-knee amputation in this difficult population.