The Clinical Efficacy Of Vancomycin Bone Cement For Intramedullary Infection After Fracture Surgery

Objective: Intramedullary infection after internal fixation is one of a relativelycommon postoperative complications. To the orthopaedic surgeon, it is still a difficultproblem in the clinical treatment. There are many kinds of treatments, but it does nothave a particular effective treatment method. Through observing the selection ofappropriate clinical patients, the implementation of vancomycin bone cement fillingmethod, the observation after surgery inflammation disappeared, two aspects of thewound healing, the infection control, we explore the cement used to vancomycin bonefracture fixation postoperative intramedullary the clinical curative effect of infection, Toprovide a new train of thought to choose the methods of the treatment of internalfixation for clinical treatment of postoperative intramedullary infectionMethod:retrospective analysis from January2009to May2012, our (the secondaffiliated hospital of dalian medical university)20patients was conducted as the objectof research, clinical data analysis. Male in14cases, female in6cases, aged from20to64years, average age,38.2years; Among them open fractures in14cases, closedfractures in6, sick time, on February-December, an average of six months, before thenumber1-3times surgery, an average of1.5times. The part: the femur in4cases,6cases of tibial, humerus in7cases,3cases of radial feet. According to come on time isdivided into:6cases of early postoperative infection,9cases of postoperative infectionfor delay,5cases of postoperative infection late; According to Cierny-Maderclassification:16cases of Ⅳ type A,2cases of type IA,2cases of IIIA type.Preoperative20patients fistula secretion,10cases of training for staphylococcus aureuspositive, six cases of staphylococcus epidermidis.2cases of mixed infection,2cases ofhemolytic streptococcus infection.15patients was removed internal fixation devices,debridement cavity filling vancomycin bone cement; six months later when theinfection was controled, the second phase was removed, then a bone graft fixation was done autogenous iliac again.5patients was took out the old fixation, debrided a periodof bone fixation combined vancomycin bone cement treatment.Result: The20patients were all followed-up, the average follow-up period was12months (9-24months).20cases get control of19cases, treatment3to6months,average4.3months. Among them,15cases debridement vancomycin bone werecemented into patients,1case did not controll infection, after debridement againvancomycin bone was cemented into, infection was got control;4underwentdebridement from a period of ilium body bone plate fixation combined vancomycinbone cement cureed patients were all got control of the infection.Conclusion: The complete debridement, vancomycin bone cement can effectivelycontrol the infection and reduce the recurrence, which is a effective method of thetreatment of internal fixation intramedullary infection.