Antibiotics bone cement combined with Ilizaror technique in the treatment of infectious large segmental bone defects of femur and tibia
ZHENG Ren-quan;KANG Ji;ZHANG Gui-chun;Bone Traumatic Surgery,No.960 Hospital of PLA;
Objective To investigate the efficacy of antibiotics bone cement combined with Ilizarov technique in the treatment of infectious large segmental bone defects of femur and tibia. Methods The 12 patients with infectious large segmental bone defects after femoral and tibial fractures. Who admitted in the General Hospital of Jinan Military Region from June 2010 to April 2015,received antibiotic bone cement combined with Ilizarov technique. The operation was performed in two stages:Thorough debridement in one stage,bone cement containing sensitive antibiotics was implanted to control infection and form an osteoinductive membrane. In the second stage,the infection was controlled. After the flap was survived,the bone cement was removed. The patient with femoral bone defect was treated with a unilateral external fixator. The patient with iliac bone defect was treated with an Ilizarov annular external fixator for bone extension. Bone grafting,the external fixation index(EFI) and ASAMI evaluation criteria were used. Results All the patients were followed up for 19 to 26 months with an average of 23.5 months. The external fixator was fixed for 9.8 to 17.6 months with an average of 12.7 months,and the average external fixator index(EFI) was 1.52 months/cm. ASAMI evaluation criteria,bone results:excellent in 7 cases,good in 4 cases,and in 1 case,the excellent and good rate was91.67%;functional results:excellent in 3 cases,good in 7 cases,and in 2 cases,the excellent and good rate was83.33%. All the patients had no recurrence of limb infection,and all achieved bone healing,7 cases of nail infection,2 cases of poor line,3 cases of loose needle,and achieved good results after symptomatic treatment.Conclusion Antibiotic bone cement combined with Ilizarov technology can not only effectively control infection,correct limb deformity,but also reconstruct limb function. It is an effective method for the treatment of infectious large segmental bone defects of femur and tibia.