A simple method for fashioning an antibiotic impregnated cemented rod for intramedullary placement in infected non-union of long bones

摘要

The intramedullary insertion of antibiotic impregnated PMMA rods, beads or nails are widely used and accepted modality of treatment for chronic osteomyelitis of long bones. But at times it becomes difficult to insert and remove these antibiotic delivery systems owing to narrowed medullary canals. Here we present a technique for preparing PMMA rods with diameter ranging from 6 mm to 3 mm. These rods could easily be placed in narrow intramedullary canal of long bones with chronic osteomyelitis or infected non-union.We have used high viscosity bone cement (Simplex P) along with two antibiotics (cefuroxime and vancomycin) for preparing cement rods. Food grade straw and low profile teflon tube guide wire exchanger used in IM nailing were used as mold. Ilizarov wire, 1 mm K wire and 24 gauge stainless steel wire were used as internal support core material for imparting strength. We used this technique in seven cases and were successful in treating infection of long bones of upper and lower limbs (femur). With average follow up of 7.28 months rate of union in our series was 71% (five cases). Four cases (57%) had no evidence of infection and two cases (29%) had control of infection and in one case (14%) infection was still there but union was achieved.