N°008 - November / December 2020
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Management of infections with antibiotic bone cement in trauma and orthopedic surgery
By T. Ferry 1, O. Borens 2, M. Reed 3 in category SURGICAL TECHNIQUE
1- Service de Maladies Infectieuses et Tropicales - CRIOAC, Hôpital de la Croix-Rousse, Hospices Civils de Lyon, Lyon, France. 2- Service d’orthopédie et de traumatologie de l’appareil locomoteur, Département de l’appareil locomoteur, CHUV, 1011 Lausanne. 3- Northumbria Healthcare NHS Foundation Trust, Woodhorn Lane, Ashington, Northumberland NE63 9JJ, UK.
Over the past few years, arthroplasty and trauma surgery has made significant progress, and has become increasingly accurate and effective. However, osteoarticular infections remain a major public health problem and their management may be challenging. Failures in the treatment of these osteoarticular infections have major functional consequences for patients. The use of antibiotic bone cement is an essential tool in the management of these osteoarticular infections and must be mastered by the orthopedic surgeon. The aim of this article is to report and discuss the three indications for the use of antibiotic bone cement in trauma and orthopedics.
1. Management of open fractures with major bone defects
Gustilo III open fractures secondary to high-kinetic trauma pose two main treatment problems. Skin opening and injury to the soft tissues lead to a high risk of infection. Fractures, in particular those of the leg, may be accompanied by a major bone defect, requiring potentially complex bone reconstruction that may not be feasible at an early stage. In these circumstances, the use of a temporary antibiotic bone cement spacer provides benefits in the management of these two problems. When extensive soft tissue lesions associated with bone defects of varying...
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