Antibiotic cement rod to control infection in infected humerus nonunion

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Rodrigo Brandariz
Javier Bennice
Jorge Boretto
Ezequiel Zaidenberg
Pablo De Carli
Gerardo Gallucci

Abstract

Objetive: To evaluate the efficiency of the antibiotic cement rod (ACR) in the eradication of infection in infected humerusnonunion (IHN).Material and methods: We included 11 patients with IHN with a mean age of 48 years. The time between fracture-surgery was 25 months. The ACR was impregnated with vancomycin in 9 of de 11 cases. Follow-up was 54 months.Results: Methicillinresistant staphylococcus aureus (MRSA) was isolated in 5 of cases. All patients received antibiotics systemically for 7 weeks. Vancomycin was the most commonly used antibiotic. Time between ACR and reconstructive surgery averaged 56 days [confidence interval range (CIR) 47-98]. After debridement and implant removal, the residual space of the nonunion was measured with dichotomous variables and classified into two groups: group 1, < 2 cm (7 patients) and group 2, ≥2 cm (4 patients).  No significant differences were observed between the number of days in which the ACR was placed and the development of the SAMR as compared to other germs [48 days (CIR 45-75) vs. 73 days (CIR 56-149) p= 0.2002 Mann Whitney]. Nor were differences observed in the size of the defect in those who developed MRS or any other germ (p=0.242 Fisher). Reconstruction was performed with different techniques. Laboratory parameters were normal, cultures were negative. Fractures could be consolidated without infection recurrence.Conclusions: ACR is a good treatment option for a patient with an INH. The infection could be controlled in all of the cases, which allowed the secondary reconstruction of the nonunion

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How to Cite
Brandariz, R., Bennice, J., Boretto, J., Zaidenberg, E., De Carli, P., & Gallucci, G. (2019). Antibiotic cement rod to control infection in infected humerus nonunion. Revista De La Asociación Argentina De Ortopedia Y Traumatología, 84(2), 90-98. https://doi.org/10.15417/issn.1852-7434.2019.84.2.849
Section
Clinical Research
Author Biographies

Rodrigo Brandariz, Hospital Italiano de Buenos Aires, Ciudad Autónoma de Buenos Aires, Argentina

Sector de Cirugía de Mano y Miembro Superior, Instituto de Ortopedia y Trauamatología "Dr. Prof. Carlos E. Ottolenghi", Hospital Italiano de Buenos Aires, Ciudad Autónoma de Buenos Aires, Argentina

Javier Bennice, Hospital Italiano de Buenos Aires, Ciudad Autónoma de Buenos Aires, Argentina

Sector de Cirugía de Mano y Miembro Superior, Instituto de Ortopedia y Trauamatología "Dr. Prof. Carlos E. Ottolenghi", Hospital Italiano de Buenos Aires, Ciudad Autónoma de Buenos Aires, Argentina

Jorge Boretto, Hospital Italiano de Buenos Aires, Ciudad Autónoma de Buenos Aires, Argentina

Sector de Cirugía de Mano y Miembro Superior, Instituto de Ortopedia y Trauamatología "Dr. Prof. Carlos E. Ottolenghi", Hospital Italiano de Buenos Aires, Ciudad Autónoma de Buenos Aires, Argentina

Ezequiel Zaidenberg, Hospital Italiano de Buenos Aires, Ciudad Autónoma de Buenos Aires, Argentina

Sector de Cirugía de Mano y Miembro Superior, Instituto de Ortopedia y Trauamatología "Dr. Prof. Carlos E. Ottolenghi", Hospital Italiano de Buenos Aires, Ciudad Autónoma de Buenos Aires, Argentina

Pablo De Carli, Hospital Italiano de Buenos Aires, Ciudad Autónoma de Buenos Aires, Argentina

Sector de Cirugía de Mano y Miembro Superior, Instituto de Ortopedia y Trauamatología "Dr. Prof. Carlos E. Ottolenghi", Hospital Italiano de Buenos Aires, Ciudad Autónoma de Buenos Aires, Argentina

Gerardo Gallucci, Hospital Italiano de Buenos Aires, Ciudad Autónoma de Buenos Aires, Argentina

Sector de Cirugía de Mano y Miembro Superior, Instituto de Ortopedia y Trauamatología "Dr. Prof. Carlos E. Ottolenghi", Hospital Italiano de Buenos Aires, Ciudad Autónoma de Buenos Aires, Argentina

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