J Korean Fract Soc.  2000 Oct;13(4):884-890. 10.12671/jksf.2000.13.4.884.

Two-Stage Treatment of Infected Nonunion of the Tibia using Antibiotics Impregnated Cement Beads and External Fixator

• Jeong YC

• KMID: 2100155
• DOI: http://doi.org/10.12671/jksf.2000.13.4.884

Abstract

PURPOSE: To evaluate the results of two-stage treatment for infected nonunion of the tibia using antibiotics impregnated cement beads(AICB) and external skeletal fixation.
MATERIALS AND METHODS
We analyzed 25 infected tibial nonuinon that were treated with AICB and external skeletal fixation from July 1995 to April 1998. The average follow-up was 25 months. In the first stage, sequestrectomy and radical debridement was performed. and then the soft tissue and bony defects were filled with AICB and was stabilized with external skeletal fixation. In the second stage, after removal of AICB and the nonunion site was either grafted with autogenous cancellous bone graft(17 patients) or internal bone transport(8 patients) was performed according to the bone defect size.
RESULTS
The average bony union time was 36.8 weeks. The intervening time between the first and second stages of treatment was 4 to 6 weeks (average 5.4 weeks). There were 8 pin tract infections, 1 Postoperative infection after the second-stage bone grafting. According to Paley's functional assessment system, excellent or good results were obtained in 20 cases. There was no poor result.
CONCLUSION
In our opinion, the above advocated two-stage treatment is an acceptable treatment modality for the management of infected tibial nonunion.

Keyword

Tibia; Infected nonunion; Antibiotics impregnated cement beads; External fixation; Two-stage treatment

MeSH Terms

Anti-Bacterial Agents*
Bone Transplantation
Debridement
External Fixators*
Follow-Up Studies
Fracture Fixation
Tibia*
Transplants
Anti-Bacterial Agents