CUSTOM-MADE ANTIBIOTIC-IMPREGNATED CEMENT INTRAMEDULLARY LOCKED NAILS IN INFECTED NONUNION OF LOWER EXTREMITY

Problems of infected non-unions include not only infection and impossibility of weight-bearing, but also restricted ROM and compromised soft-tissues as result of trauma and previous surgeries. In such cases, treatment is long and difficult both for patient and treating surgeon. This study was performed to evaluate the efficacy of using antibiotic-impregnated cement locked nails for management of this condition.The study included 28 patients with infected non-unions of femur (18) and tibia (10) treated from 01.2009 to 11.2013. Mean time from the injury to AB-cement nailing was 16.5(9–27) months. 4/18 femoral and 5/10 tibial fractures were open. Other fractures were closed and infected non-union developed as complication of previous surgeries: IM-nailing, ORIF or Ilizarov external fixation. Fistulas were revealed in all patients, but have closed by the time of AB-cement nailing in 18 cases. Pre- and intraoperative cultures revealed S.aureus in 18, S.epidermidis in 5, no grows in 5 cases. Solid stainless-ste...