扩髓灌洗联合抗生素骨水泥涂层髓内钉内固定治疗胫骨骨折髓内钉内固定术后感染

目的 探讨扩髓灌洗并更换成含抗生素骨水泥涂层髓内钉内固定治疗胫骨骨折髓内钉内固定术后感染的临床疗效.方法 回顾性分析自2012-06-2018-12诊治的10例胫骨骨折髓内钉内固定术后感染,术中扩大髓腔进行髓腔灌洗、彻底清创,然后更换成含抗生素骨水泥涂层髓内钉一期内固定胫骨骨折.3例经窦道清创切除感染骨后用抗生素骨水泥...

Reaming lavage and replacing antibiotic bone cement coated intramedullary nail internal fixation to treat tibial fracture infection after intramedullary nail internal fixation

ObjectiveTo investigate the clinical effect of reaming and lavage and replacement of antibiotic bone cement coated intramedullary nail internal fixation in the treatment of tibial fracture infection after intramedullary nail internal fixation.MethodsA retrospective analysis of 10 cases of tibial fractures with infection after intramedullary nail internal fixation treated from June 2012 to December 2018 was performed.During the operation,the medullary cavity was expanded,and lavaged,and the wound was thoroughly debrided,and then the antibiotic bone cement coating intramedullary nail internal fixation was replaced.The fracture was fixed by nailing within one period.In 3 cases,the infected bone was removed via sinus debridement and the bone defect was filled with antibiotic bone cement.After 8 weeks,the bone cement was removed and autologous cancellous bone particles were grafted.ResultsAll 10 cases were followed up with an average follow-up time of 28(12-48)months.All patients had no recurrence of infection and no fracture again.The average healing time of tibial fractures in 7 cases without bone defect was 5(4.0-5.5)months.The fracture healing time of 3 cases of bone defect with autogenous iliac bone grafting was 4,5,and 6 months,with an average of 5 months.Three patients developed prepatellar pain within 1 year after surgery,and were cured after rehabilitation and physical therapy.ConclusionReaming lavage and replacing the antibiotic bone cement coating intramedullary nail internal fixation is an effective treatment for infection after tibial fracture treated with intramedullary nail internal fixation,with short treatment cycle,high infection cure rate,and it is conducive to fracture healing.