Role of antibiotic-impregnated cement intramedullary nail in infected nonunion of long bone diaphyseal fractures

Abstract

Introduction: Infected nonunion of long bones is a chronic and debilitating disorder to manage. The problems in treating them are infection, instability, and deformity. This study aims to evaluate the effectiveness of antibiotic-impregnated intramedullary nail as a management for infected nonunion of long bones. Materials and Methods: A total of 12 cases of infected nonunion of long bones (10 – tibia and 2 – femur) without bone loss and age group of more than 18 years are treated using antibiotic cement-coated k-nail. Antibiotics used are vancomycin 4 g and clindamycin 2 g. The average duration of retention of antibiotic nail was 24 weeks. Results: At follow-up, infection was controlled in 90% of cases. Bony union achieved in 8 out of 12 cases (66%). Rest 4 cases required further additional procedures. Recurrence of infection occurred in two cases. Conclusions: This is a very effective and economical with better patient compliance. This method achieves infection control, promotes bone union, and mechanical stability.