Reaming and cement spacer implantation for the treatment of bone infection after intramedullary nailing

Abstract

Abstract Background The aim of this study was to investigate the clinical efficacy of reaming and cement spacer implantation for the treatment of bone infection after intramedullary nailing. Methods Retrospective analysis the patients with lower extremities infection after intramedullary nailing admitted to our hospital between February 2013 and April 2020. In the first stage, reaming and cement spacer implantation were performed and the defects were filled with antibiotic cement spacer. In the second stage, the patients were divided into repaired group and non-repaired group according to whether the bone defects were repaired or not. The infection control rate and complications of the two groups were compared. Results A total of 69 patients were admitted to this study, there were 37 tibias and 32 femurs. The average follow-up time was 38.82 months. After the first stage debridement surgery. There were 6 patients in repaired group, and 8 patients in non-repaired group recurrence of infection which need debridement again, the infection rate of repaired group was lower than that of non-repaired group, P = 0.038. Finally, the overall infection control rate was 97.1%, which was 100% in repaired group and 91.30% in non-repaired group, P = 0.108. The overall complication rate was 17.39%, and there was no significant difference between the two groups. Conclusion The efficacy of reaming and cement spacer implantation for the treatment of bone infection after intramedullary nailing is satisfactory, but repeated debridement may be required to improve the infection control rate. The recurrence rate of infection was higher in patients who had not undergone bone defects repaired for a long time.