Quick antiinfective spacer combined with Masquelet technique for treatment of infectious bone defects

Abstract

Objective To investigate the efficacy of quick antiinfective spacer combined with Masquelet technique in the treatment of infectious bone defects. Methods From January 2006 to June 2013, we treated 52 patients with infectious bone defects. They were 46 men and 6 women, aged from 19 to 46 years (average, 31.3 years). They were treated by debridement and anti-infection therapy at the first stage when the individualized quick antiinfective spacers were prepared (a mixture of antibiotics and bone cement powder added by polymethyl methacrylate morphon). At the second stage, the bone defects were repaired using Masquelet technique before they were internally fixated. Results The 52 patients were followed up for an average time of 21 months (range, from 13 to 28 months). All the infectious bone defects were healed. X-ray examination showed that the bone mineral density at the bone grafting area increased significantly compared with pre-operation, suggesting granular bone resorption and new bone formation. All the fractures obtained bony union after 6 to 10 months (average, 7.5 months), without recurrence of infection or teratogenesis. Conclusions Quick antiinfective spacer can control local infection in the early period of bone defect by sustainable local release of effective antibiotics of high concentrations while it maintains limb length, increases the stability of fracture ends, and reduces contracture of bone and soft tissue. All these roles may create favorable conditions for late repair, reduce the infection rate and improve the efficacy of early management. Key words: Fractures, bone; Infection; Masquelet technique; Wound and injuries; Fracture fixation, internal