» Articles » PMID: 38910811

Acute Prophylactic Antibiotic Nailing of Open Femoral Shaft Fractures for Prevention of Fracture-related Infection

Overview
Specialty General Medicine
Date 2024 Jun 24
PMID 38910811
Authors
Affiliations
Soon will be listed here.
Abstract

Background: Open, grossly contaminated femoral shaft fractures pose a significant threat for fracture-related infection. Traditional treatment for these injuries consists of irrigation and debridement with temporizing external fixation placement and staged conversion to definitive fixation.

Methods: We describe a protocol for acute antibiotic cement nailing of open femoral shaft fractures as an infection prophylaxis modality in fractures with a high risk of infection and present three cases.

Results: Three patients presented with open femoral shaft fractures with large soft tissue defects and gross contamination and were successfully treated with acute retrograde antibiotic nailing and external fixation with later conversion to definitive metallic nailing. They did not develop infection and had acceptable postoperative function and fracture alignment.

Conclusion: This technique of early infection prophylaxis after open femoral shaft fracture is reproducible, pragmatic, and cost-effective.

References
1.
Alonso J, GEISSLER W, Hughes J . External fixation of femoral fractures. Indications and limitations. Clin Orthop Relat Res. 1989; (241):83-8. View

2.
Hughes L, Anugraha A, Pillai A . A novel technique for fabricating antibiotic-coated intramedullary nails using an antibiotic-loaded calcium sulphate hydroxyapatite bio-composite, Cerament-V. J Surg Case Rep. 2019; 2019(11):rjz327. PMC: 6883910. DOI: 10.1093/jscr/rjz327. View

3.
Kalbas Y, Klingebiel F, Pape H . Antibiotic coated nails: Rationale, development, indications and outcomes. J Orthop Surg (Hong Kong). 2022; 30(3):10225536221118521. DOI: 10.1177/10225536221118521. View

4.
Ismat A, Walter N, Baertl S, Mika J, Lang S, Kerschbaum M . Antibiotic cement coating in orthopedic surgery: a systematic review of reported clinical techniques. J Orthop Traumatol. 2021; 22(1):56. PMC: 8702599. DOI: 10.1186/s10195-021-00614-7. View

5.
Ohtsuka H, Yokoyama K, Higashi K, Tsutsumi A, Fukushima N, Noumi T . Use of antibiotic-impregnated bone cement nail to treat septic nonunion after open tibial fracture. J Trauma. 2002; 52(2):364-6. DOI: 10.1097/00005373-200202000-00025. View