Treatment of Post-traumatic Bone Defects with infection in long bones

  • Hari Om Agarwal Associate Professor, Deptt of Orthopaedics, Govt Medical College, Patiala
  • Harjit K. Singh Chawla Assistant Professor, Deptt of Orthopaedics, Govt Medical College, Patiala
  • Ashish Garg Senior Resident, Deptt of Orthopaedics, All India Institute of Medical Sciences, Bathinda
  • Girish Sahni Associate Professor, Deptt of Orthopaedics, Govt Medical College, Patiala
Keywords: Antibiotic cement spacer, induced biomembrane bone grafting, management of bone defect, management of compound fractures, Masquelet technique

Abstract

Introduction: Open fractures are a challenging condition to treat because they are frequently compounded by infection and nonunion. Traditional bone defect care strategies are mostly focused on fracture union rather than infection prevention. The goal of this study is to use the Masquelet approach to examine the outcome of a post-traumatic defect with infection in long bones. This method is a two-step process. Stage I surgery includes debridement and the placement of an antibacterial spacer in the bone defect. Stage II surgery involved removing the spacer while preserving the induced membrane that had grown on the spacer's surface and filling the bone-gap with morselized iliac crest bone-graft within the membrane sleeve.

Materials and Methods: There were 22 patients in this study (18 males and 4 females), all of them had infected long bone fractures with a bone defect. The average length of the bone defect was 3.5 centimetres. The duration of follow-up varied from 6 to 15 months.

Results: After an average of 11.5 weeks following the first step of surgery, radiological union was achieved. After stage 1, no patient had any remaining infection. After radiological union, all of the patients were able to mobilise with full weight bearing and a satisfactory range of motion in the adjoining joints.

Conclusion: With favourable outcomes, this treatment can be used on infected fractures with bone loss on a regular basis. Antibiotic cement spacers, used in conjunction with complete debridement, minimise the risk of infection. The graft is revascularized through induced biomembrane. In most circumstances, union may be predicted; nonetheless, the length of time it takes to reach an agreement is a constraint. The technique is low-cost and does not necessitate any additional training or equipment. Despite the fact that it is a two-stage procedure, it does not necessitate several surgeries as in traditional approaches.

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Published
2022-05-11
How to Cite
1.
Agarwal HO, Chawla HKS, Garg A, Sahni G. Treatment of Post-traumatic Bone Defects with infection in long bones . Int Arch BioMed Clin Res [Internet]. 2022May11 [cited 2022May25];8(1):OT1-OT3. Available from: https://iabcr.org/index.php/iabcr/article/view/789
Section
ORIGINAL ARTICLES ~ Orthopaedics