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Role of Antibiotic Cement-coated Nailing in Infected Nonunion of Tibia

May 10, 2018/in May - Aug | volume 4 | issue 1| 2018

Vol 4 | Issue 1 | May – Aug 2018 | page: 18-21 | Clevio Desouza,Vinod Nair, Amit Chaudhary, Harshal Hurkat, Shiju George. Author: Clevio Desouza [1],Vinod Nair [1], Amit Chaudhary [1], Harshal Hurkat [1], Shiju George [1]. [1] Department of Orthopaedics, Dr D.Y.Patil Hospital, Pune, Maharashtra, India. Address of Correspondence Dr. Clevio Desouza, Department of […]

Cannulated Schanz Pin: A Novel Concept for Intraosseous Antibiotic Delivery

May 10, 2018/in May - Aug | volume 4 | issue 1| 2018

Vol 4 | Issue 1 | May – Aug 2018 | page: 15-17 | Ninad Ashok Godghate, Neha Ninad Godghate, Ashok Shyam, Krishnamohan Ananda Saindane Author: Ninad Ashok Godghate [1], Neha Ninad Godghate [1], Ashok Shyam [2], Krishnamohan Ananda Saindane [3]. [1] Consultant Grace Ortho Clinic Rajiv Nagar T-Point Wardha Road, Nagpur. [2] Sancheti Institute, Pune […]

Role of Antibiotic Cement-coated Nailing in Infected Nonunion of Tibia

May 10, 2018/in May - Aug | volume 4 | issue 1| 2018

Cannulated Schanz Pin: A Novel Concept for Intraosseous Antibiotic Delivery

May 10, 2018/in May - Aug | volume 4 | issue 1| 2018

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Role of Antibiotic Cement-coated Nailing in Infected Nonunion of Tibia

May 10, 2018/in May - Aug | volume 4 | issue 1| 2018

Vol 4 | Issue 1 | May – Aug 2018 | page: 18-21 | Clevio Desouza,Vinod Nair, Amit Chaudhary, Harshal Hurkat, Shiju George.

Author: Clevio Desouza [1],Vinod Nair [1], Amit Chaudhary [1], Harshal Hurkat [1], Shiju George [1].

[1] Department of Orthopaedics, Dr D.Y.Patil Hospital, Pune, Maharashtra, India.

Address of Correspondence
Dr. Clevio Desouza,
Department of Orthopaedics, Dr D.Y.Patil Hospital, Pune, Maharashtra, India.
E-mail: ceviod@gmail.com

Abstract

Introduction: The infection of long bones along with its nonunion is a chronic and debilitating disorder. It becomes difficult to deal with the situation in which the implant which is used for internal fixation itself becomes a potential media for infection because of the formation of biofilms and adhesions. Traditionally, this situation is managed by a two-stage procedure for controlling the infection first and then treating the nonunion. This study has been undertaken to explore antibiotic cement-coated nailing as a single stage treatment modality for achieving stability and treating of the infection at the same time.
Materials and Methods: 20 patients (above 18years of age) with nonunion of tibia associated with infection with bone gap <2 cm were managed using antibiotic cement-coated Kuntscher nail. Antibiotics used were a combination of vancomycin and teicoplanin.
Results: Infection was controlled in 95% of the patients. Bony union was achieved in 12 of 20 (60%) patients with antibiotic cement nailing as the only procedure with average time of union of 32 weeks. Bone grafting or exchange nailing type additional procedures were required in the remaining eight patients, and this was done in six patients, with union of the fracture. Two patients refused to undergo further procedures. The various complications encountered during this study were difficult nail removal in three cases, broken nail in two cases, and bent nail in 1 case. Recurrence of infection was observed in two patients. The average period of follow-up was 12 months.
Conclusion: Antibiotic cement impregnated nailing is a simple, economical, and effective single-stage procedure for the management of infected nonunion of the tibia. It has many advantages over external fixators, as it eliminates the complications and has good patient compliance. The method utilizes existing easily available instrumentation and is technically demanding and therefore can be performed at any hospital.
Keywords: Nonunion, infected, antibiotic, cement, nailing.

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How to Cite this article: Desouza C, Nair V, Chaudhary A, Hurkat H, George S. Role of Antibiotic Cement-coated Nailing in InfectedNonunion of Tibia. Trauma International May-Aug 2018;4(1):18-21.

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Cannulated Schanz Pin: A Novel Concept for Intraosseous Antibiotic Delivery

May 10, 2018/in May - Aug | volume 4 | issue 1| 2018

Vol 4 | Issue 1 | May – Aug 2018 | page: 15-17 | Ninad Ashok Godghate, Neha Ninad Godghate, Ashok Shyam, Krishnamohan Ananda Saindane

Author: Ninad Ashok Godghate [1], Neha Ninad Godghate [1], Ashok Shyam [2], Krishnamohan Ananda Saindane [3].

[1] Consultant Grace Ortho Clinic Rajiv Nagar T-Point Wardha Road, Nagpur.
[2] Sancheti Institute, Pune
[3] FICS, Consultant, Suyog Hospital, Sakri road, Dhule.

Address of Correspondence
Dr. Ninad Ashok Godghate,
Consultant Grace Ortho Clinic Rajiv Nagar T-Point Wardha Road, Nagpur.
Email: drninadgodghate@gmail.com

Abstract

Infection control and prevention is the first step in any orthopaedic procedure because its treatment can be challenging and complicated. Complex bony architecture, precarious blood supply and presence of biofilm make eradicating infection a difficult task. Local antibiotic delivery in such cases has proved successful as it provides high concentration of antimicrobial agents and prevents systemic toxicity that is associated with systemic antibiotic administration. Of all the options available at present for local delivery, the most commonly used is antibiotic loaded bone cement. However only heat stable antibiotics can be used with cement and studies show that amount of drug eluted from the cement decreases with time. We have attempted to address these drawbacks and make local administration of antibiotics simpler by a novel method which could be used for treatment of established infections as well as prevention of infection in open fractures. This method could allow use of sensitive and specific antibiotic in addition to providing fracture stability.
Keywords: Infection, intraosseous antibiotic delivery, cannulated schanz pin

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How to Cite this article: Godghate N A, Godghate N N, Shyam A, Saindane K A. Cannulated schanz pin: A novel concept for intraosseous antibiotic delivery. Trauma International May- Aug 2018;4(1):15-17.

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Role of Antibiotic Cement-coated Nailing in Infected Nonunion of Tibia

Cannulated Schanz Pin: A Novel Concept for Intraosseous Antibiotic Delivery

Role of Antibiotic Cement-coated Nailing in Infected Nonunion of Tibia

Cannulated Schanz Pin: A Novel Concept for Intraosseous Antibiotic Delivery

Full Sized Blog Element (Big Preview Pic)

Role of Antibiotic Cement-coated Nailing in Infected Nonunion of Tibia

Author: Clevio Desouza [1],Vinod Nair [1], Amit Chaudhary [1], Harshal Hurkat [1], Shiju George [1].

Abstract

References

(Abstract Text HTML) (Download PDF)

Cannulated Schanz Pin: A Novel Concept for Intraosseous Antibiotic Delivery

Author: Ninad Ashok Godghate [1], Neha Ninad Godghate [1], Ashok Shyam [2], Krishnamohan Ananda Saindane [3].

Abstract

References

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