Intramedullary Canal Injection of Vancomycin- and Tobramycin-loaded Calcium Sulfate: A Novel Technique for the Treatment of Chronic Intramedullary Osteomyelitis.

IF 1 Q3 ORTHOPEDICS

Strategies in Trauma and Limb Reconstruction Pub Date : 2022-05-01 DOI:10.5005/jp-journals-10080-1554

Ahmed H Elhessy, Jessica C Rivera, Henry T Shu, Taj-Jamal Andrews, John E Herzenberg, Janet D Conway

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引用次数: 5

Abstract

Aim: In this study, we present a detailed surgical technique for treating chronic osteomyelitis (COM) of the intramedullary canal with injectable tobramycin and vancomycin-loaded calcium sulfate (CS).

Background: Chronic osteomyelitis of the long bones has been treated using antibiotic-impregnated polymethyl methacrylate (PMMA), which typically requires a second procedure for removal.

Technique: Removal of the infected intramedullary nail (if any), copious irrigation, canal reaming, and intramedullary canal injection of vancomycin- and tobramycin-loaded calcium sulfate as a single-stage procedure for the treatment of COM of long bones.

Conclusion: Intramedullary injection of vancomycin- and tobramycin-loaded CS can be used as a single-stage procedure for the treatment of long bone intramedullary COM. Further studies are necessary to compare the long-term outcomes of antibiotic-coated CS vs other antibiotic carriers for infection eradication.

Clinical significance: The authors have endeavored to explain the best surgical technique to eradicate long bones COM with injectable tobramycin and vancomycin-loaded CS.

How to cite this article: Elhessy AH, Rivera JC, Shu HT, et al. Intramedullary Canal Injection of Vancomycin- and Tobramycin-loaded Calcium Sulfate: A Novel Technique for the Treatment of Chronic Intramedullary Osteomyelitis. Strategies Trauma Limb Reconstr 2022;17(2):123-130.

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髓管内注射万古霉素和妥布霉素负载硫酸钙:治疗慢性髓内骨髓炎的新技术。

目的:在本研究中，我们提出了一种详细的手术技术，用于治疗慢性骨髓炎(COM)的髓内管注射妥布霉素和万古霉素负载硫酸钙(CS)。背景:长骨慢性骨髓炎已经使用抗生素浸渍的聚甲基丙烯酸甲酯(PMMA)治疗，通常需要第二次手术去除。技术:去除感染的髓内钉(如果有)，大量冲洗，扩管，髓内注射万古霉素和妥布霉素硫酸钙，作为治疗长骨COM的单阶段手术。结论:万古霉素和妥布霉素负载CS髓内注射可作为治疗长骨髓内COM的单期手术。需要进一步的研究来比较抗生素包被的CS与其他抗生素载体根除感染的长期结果。临床意义:作者试图解释注射妥布霉素和万古霉素加载CS根除长骨COM的最佳手术技术。如何引用本文:Elhessy AH, Rivera JC, Shu HT等。髓管内注射万古霉素和妥布霉素负载硫酸钙:治疗慢性髓内骨髓炎的新技术。创伤肢体重建2022;17(2):123-130。

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来源期刊

Strategies in Trauma and Limb Reconstruction Medicine-Orthopedics and Sports Medicine

CiteScore

1.50

自引率

0.00%

发文量

期刊介绍： Strategies in Trauma and Limb Reconstruction is dedicated to surgeons, allied medical professionals and researchers in the field of orthopaedics and trauma. The scope of the journal is to discuss the fields of skeletal injury, and the complications thereof, congenital and acquired limb deformities and deficiencies, and orthopaedic-related infection, together with their surgical and non-surgical treatments. The journal publishes original articles, reviews, case reports, descriptions of new or recognised treatment techniques, forum discussions of clinical scenarios and relevant correspondence. It aims to provide a widely accessible source of useful information to practitioners in the field through the problem- or technique-based approach of published articles.