Antibiotic-loaded cement: A viable alternative to amputation in the treatment of diabetic foot osteomyelitis - A case report

Abstract

This article shows the long-term success of surgical debridement and antibiotic-loaded cement spacers, as an alternative to amputation, in a 32-year-old male diabetic Type I patient with Osteomyelitis (OM) of first metatarsal base and medial cuneiform of the left foot. OM is a common complication of diabetic foot infections and when it involves the proximal phalanx or metatarsal head, amputation at the Lisfranc ligament level is the recommended treatment. However, its management is not well standardized yet. The objective of this article is to describe the treatment with bone curettage and filling with antibiotic-loaded cement and its mid-term clinical outcomes, as an alternative to usual management. Local antibiotic treatment with cement could be equally effective as amputation without the morbid and functional implications that the latter option entails, nevertheless more evidence is required to develop general recommendations.