دورية أكاديمية
أعرض في EDS

Antibiotic cement-coated rigid locked nails in infected femoral and tibial nonunion. Reoperation rates of commercial versus custom-made nails.

التفاصيل البيبلوغرافية
العنوان: Antibiotic cement-coated rigid locked nails in infected femoral and tibial nonunion. Reoperation rates of commercial versus custom-made nails.
المؤلفون: Garabano G; Orthopaedic and Trauma Surgery Department, British Hospital of Buenos Aires, Perdriel 74, C1280 AEB, Buenos Aires, Argentina. Electronic address: ggarabano@hbritanico.com.ar., Pereira S; Orthopaedic and Trauma Surgery Department, Sirio - Libanes Hospital, Campana 4658, C1419, Buenos Aires, Argentina., Alamino LP; Orthopaedic and Trauma Surgery Department, British Hospital of Buenos Aires, Perdriel 74, C1280 AEB, Buenos Aires, Argentina., Munera MA; Orthopaedic and Trauma Surgery Department, Sirio - Libanes Hospital, Campana 4658, C1419, Buenos Aires, Argentina., Ernst G; Scientific Advisory Committee, British Hospital of Buenos Aires, Buenos Aires, Argentina., Bidolegui F; Orthopaedic and Trauma Surgery Department, Sirio - Libanes Hospital, Campana 4658, C1419, Buenos Aires, Argentina., Pesciallo CA; Orthopaedic and Trauma Surgery Department, British Hospital of Buenos Aires, Perdriel 74, C1280 AEB, Buenos Aires, Argentina.
المصدر: Injury [Injury] 2023 Nov; Vol. 54 Suppl 6, pp. 110650. Date of Electronic Publication: 2023 Feb 18.
نوع المنشور: Comparative Study; Journal Article; Observational Study
اللغة: English
بيانات الدورية: Publisher: Elsevier Country of Publication: Netherlands NLM ID: 0226040 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1879-0267 (Electronic) Linking ISSN: 00201383 NLM ISO Abbreviation: Injury Subsets: MEDLINE
أسماء مطبوعة: Publication: <2002->: Amsterdam : Elsevier
Original Publication: Bristol, Wright.
مواضيع طبية MeSH: Anti-Bacterial Agents*/administration & dosage , Bone Nails* , Tibial Fractures*/complications , Tibial Fractures*/drug therapy , Tibial Fractures*/surgery , Fractures, Ununited*/drug therapy , Fractures, Ununited*/etiology , Fractures, Ununited*/surgery , Femoral Fractures*/complications , Femoral Fractures*/drug therapy , Femoral Fractures*/surgery , Bone Diseases, Infectious*/drug therapy , Bone Diseases, Infectious*/etiology, Humans ; Bone Cements ; Femur/injuries ; Femur/surgery ; Fracture Fixation, Intramedullary/instrumentation ; Fracture Fixation, Intramedullary/methods ; Gentamicins/administration & dosage ; Reoperation ; Retrospective Studies ; Tibia/injuries ; Tibia/surgery ; Treatment Outcome ; Vancomycin/administration & dosage ; Coated Materials, Biocompatible
مستخلص: Introduction: The objective of this study is to assess bone union, infection control, and reoperation rates in a series of patients with infected femoral or tibial nonunion treated with antibiotic-cement-coated rigid nails and to compare the results obtained with custom-made nails versus commercial nails.
Methods: We retrospectively analyzed a series of consecutive patients with infected nonunion of the femur or the tibia treated with antibiotic-cement-coated rigid nails between January 2010 and 2020. We assessed patients' distinctive characteristics, initial injury, type of nail used (custom-made nail with vancomycin or commercial nail with gentamicin), success rate (bone union + infection control), reoperation rate, and failure rate. Comparative analyses were conducted between reoperated and non-reoperated patients regarding the type of nail used. A multivariate regression analysis was performed to assess the risk variables that impacted reoperation rates.
Results: We included 54 patients with 22 (40.74%) infected femoral nonunions and 32 (59.25%) tibial nonunions, who were treated with 38 (70.37%) custom-made antibiotic-cement coated nails and 16 (29.62%) commercial nails. Bone union and infection control were achieved in 51 (94.44%) cases. The reoperation rate was 40.74% (n = 22), and the failure rate was 5.55% (n = 3). The use of custom-made nails was associated with a higher risk of reoperation (Odds Ratio 4.71; 95% Confidence Interval 1.10 - 20.17; p = 0.036).
Conclusion: Antibiotic-cement-coated nails reached a 94.44% success rate. Nails manufactured in the OR coated with vancomycin cement were associated with a higher risk of reoperation than commercial nails loaded with gentamicin cement.
Level of Evidence: III comparative, observational, non-randomized.
Competing Interests: Declaration of Competing Interest None.
(Copyright © 2023 Elsevier Ltd. All rights reserved.)
التعليقات: Comment in: Injury. 2023 Nov;54(11):111049. (PMID: 37716862)
فهرسة مساهمة: Keywords: Antibiotic cement-coated nails; Femur; Gentamicin; Infected nonunion; Tibia; Vancomycin
المشرفين على المادة: 0 (Anti-Bacterial Agents)
0 (Bone Cements)
0 (Gentamicins)
6Q205EH1VU (Vancomycin)
0 (Coated Materials, Biocompatible)
تواريخ الأحداث: Date Created: 20230301 Date Completed: 20231226 Latest Revision: 20240227
رمز التحديث: 20240227
DOI: 10.1016/j.injury.2023.02.033
PMID: 36858895
قاعدة البيانات: MEDLINE
الوصف
تدمد:1879-0267
DOI:10.1016/j.injury.2023.02.033