Management of infected nonunion of the long bones by a multidisciplinary team

Bone and Joint Journal - Tập 97-B Số 6 - Trang 814-817 - 2015
Deepa Bose1, R. Kugan2, David Stubbs3, Martin McNally3
1Queen Elizabeth Hospital, Mindelsohn Way, Edgbaston, Birmingham B15 2WB, UK
2Gloucester Royal Infirmary, 8 Meadow Close, Sutton Coldfield B76 2QQ, UK.
3Oxford University Hospitals NHS Trust, Windmill Road, Oxford OX3 7HE, UK.

Tóm tắt

Infected nonunion of a long bone continues to present difficulties in management. In addition to treating the infection, it is necessary to establish bony stability, encourage fracture union and reconstruct the soft-tissue envelope.We present a series of 67 infected nonunions of a long bone in 66 patients treated in a multidisciplinary unit. The operative treatment of patients suitable for limb salvage was performed as a single procedure. Antibiotic regimes were determined by the results of microbiological culture.At a mean follow-up of 52 months (22 to 97), 59 patients (88%) had an infection-free united fracture in a functioning limb. Seven others required amputation (three as primary treatment, three after late failure of limb salvage and one for recalcitrant pain after union).The initial operation achieved union in 54 (84%) of the salvaged limbs at a mean of nine months (three to 26), with recurrence of infection in 9%. Further surgery in those limbs that remained ununited increased the union rate to 62 (97%) of the 64 limbs treated by limb salvage at final follow-up. The use of internal fixation was associated with a higher risk of recurrent infection than external fixation.Cite this article: Bone Joint J 2015; 97-B:814–17.

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Thông tin xuất bản

Bone and Joint Journal

Tập 97-B Số 6

814-817

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