Abstract

SOUTULLO, Jorge L; ARGUELLES, Santiago; RODRIGUEZ, Martín P  and  PEREIRA, Enrique. Empleo de osteosíntesis recubierta de cemento con antibiótico en el tratamiento de la osteomielitis. Presentación de dos casos. Rev. Asoc. Argent. Ortop. Traumatol. [online]. 2020, vol.85, n.4, pp.403-417. ISSN 1852-7434.  http://dx.doi.org/https://doi.org/10.15417/issn.1852-7434.2020.85.4.1004.

Treatment of osteomyelitis associated with osteosynthesis failure represents a real challenge for the orthopedic surgeon. Implant removal, surgical debridement of the affected area, and external fixation as a temporary stabilization method coupled with antibiotic therapy administered by the systemic route constitute the basis for the initial management of infections associated with implant failure. However, this combined management may prove inadequate to achieve complete control of the infection. The local use of antibiotic-loaded cement allows for maintaining a sustained agent release that reaches significantly higher concentrations than the minimum required bacterial inhibitory concentrations while reducing the associated systemic toxicity. We present two cases of osteomyelitis associated with osteosynthesis failure treated with a second osteosynthesis procedure with an antibiotic cement-coated plate. Infection control and bone union were achieved in both cases. The functional outcome was excellent with Quick-DASH scores of 6.3 and 4.5 points, respectively.

Keywords : Osteomyelitis; antibiotic cement-coated plate; osteosynthesis failure.

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