Arjun Dev Naroth Palakandy1, Manoj Murungodiyil Kunjappan2, Jose Francis3
BACKGROUND
Infected non-union is a complex, debilitating and challenging disorder affecting
orthopaedic surgeon and patient in terms of cost and time.1 Antibiotic impregnated
nail has been a cheap and effective method used for treatment of infected nonunion.
Factors that may lead to infected non-union are many.2,3 High local
concentrations of antibiotics with minimal systemic levels and without systemic
side effects make local antibiotic therapy a very useful technique in treating
infected non-union.4 Buchholz and Engelbrecht were the first to use antibiotic
impregnated cement.5 Major advantage of using antibiotic impregnated cement is,
it provides high concentration of antibiotics locally with less systemic side effects.6
The purpose of this study was to determine the functional outcome of antibiotic
impregnated nail in treatment of infected non-union of femur and tibia. Antibiotic
cement impregnated intra-medullary nail can provide stability, help in control of
infection,7 is easy to remove, and also provides all the advantages of the cement
beads.8,9
METHODS
This prospective study was done on 25 cases at Government Medical College
Thrissur from 01 September 2016 to 01 April 2018. Functional results were
evaluated with regard to control of infection, bony union, deformity, limb leg
discrepancy and complications (both intra and post-operative complications).
RESULTS
Most of the cases had type 2 open injury initially, accounting for 49 %.
Staphylococcus aureus was reported in 56 % of cases. Infection control was
achieved in 23 cases. Bony union was visualised in 18 cases, remaining 5 cases
united following bone grafting. In 2 cases there was no control of infection and no
bony union was achieved, later antibiotic nail removal and Ilizarov fixation was
planned. Bone grafting was done in 10 cases.
CONCLUSIONS
Antibiotic impregnated cement nailing is a simple, economical and very effective
procedure with less complication and shorter duration of treatment when
compared with other conventional procedures.
