Outcomes following use of large diameter antibiotic coated threaded rod for treatment of osteomyelitis

Melody John DPM , Henna Akbarzai DPM , Michael Subik DPM, FACFAS
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Abstract

The treatment of large bony defects secondary to osteomyelitis in the lower extremity continues to be a challenge in reconstructive surgery. Surgical treatment for osteomyelitis in long bones commonly entails resection of the infected portion of bone, but this often leaves a large bony defect. Masquelet technique has been successfully used in the treatment of osteomyelitis through the concept of induced membrane and the use of antibiotic impregnated polymethylmethacrylate (PMMA) cement. This retrospective case study evaluates the clinical and radiographic outcomes of using a staged approach in the treatment of lower extremity osteomyelitis in 14 patients using an intramedullary antibiotic coated threaded rod. Measured outcomes include time to radiographic fusion (5.1 weeks), time to weight bearing (3.2 weeks), hardware removal (7.14 %), need for revision surgery (7.14 %), and complications (35.71 %). Our findings support the use of a staged approach using a large antibiotic rod prior to definitive fixation as a mode of successfully treating lower extremity osteomyelitis and aiding in joint fusion.
使用大直径抗生素涂层螺纹棒治疗骨髓炎的结果
下肢骨髓炎继发大骨缺损的治疗仍然是重建外科的一个挑战。长骨骨髓炎的手术治疗通常需要切除受感染的骨部分,但这通常会留下很大的骨缺损。Masquelet技术通过诱导膜的概念和使用抗生素浸渍聚甲基丙烯酸甲酯(PMMA)水泥成功地应用于骨髓炎的治疗。本回顾性病例研究评估了使用分阶段方法治疗下肢骨髓炎的临床和影像学结果,14例患者使用髓内抗生素涂层螺纹棒。测量结果包括放射融合时间(5.1周)、负重时间(3.2周)、硬体取出时间(7.14%)、翻修手术时间(7.14%)和并发症(35.71%)。我们的研究结果支持在最终固定前使用大抗生素棒分阶段入路作为成功治疗下肢骨髓炎和辅助关节融合的模式。
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来源期刊
Foot & ankle surgery (New York, N.Y.)
Foot & ankle surgery (New York, N.Y.) Orthopedics, Sports Medicine and Rehabilitation, Podiatry
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