Abstract text (incl. references and figure legends)
Objectives:
The use of cancellous bone allografts is an established technique in bone reconstruction surgery , but its use is avoided in the presence of infection. Purified cancellous bone grafts impregnated with antibiotics ( AIBG) have shown their effectiveness as a local antibiotic delivery system.
This study evaluates the clinical and radiographic outcomes of one-stage treatment of long bone fracture-related infections (FRI) with use of AIBG .
Study Design & Methods:
24 consecutive patients with long bone FRI treated in a single stage and with a minimum follow up of 9 months were retrieved from the bone infection database at a level 1 traumacentre.
There were 17 men and 7 women with an average age of 55 years (30 to 75).
13 patients had an infected non-union and 11 patients an osteomyelitis.
Deep tissue specimens revealed in 18 out of 24 cases a single germ : 12 Staphylococcus ( 6 epidermidis); one Streptococcus; 3 Cutibacterium and 2 gram-negative. Four patients had a polymicrobial infection ; two had negative culture.
Vancomycin AIBG was used in all cases, tobramycin was used in 8 cases
In 14 cases internal fixation was performed ( 8 x plates, 4 x nails, 2 x screws)
Results:
After a mean follow-up of 16 months there were 2 recurrences of infection: one persistent clavicle nonunion infected with cutibacterium and one persistent distal tibia nonunion infected with staf epidermidis. There were two persistent nonunions without infection ( one distal femur, one distal tibia) requiring secondary stabilisation surgery
Conclusions:
Elimination of infection following one stage surgical treatment of FRI with the use of AIBG was successful in 91% of cases comparing favorably with multi stage approaches
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