Comparative Analysis Of The Effect Of Different Slow-release Antibiotic Systems Combined With One-stage Bone-moving Technique In The Treatment Of Chronic Traumatic Osteomyelitis Of Tibia

Objective: The purpose of this study was to compare the treatment of chronic tibial osteomyelitis with polymethylmethacrylate(PMMA)-based antibiotic release system and medical calcium sulfate(CSC)-based antibiotic release system combined with one-stage bone transfer technology.Clinical efficacy.Methods: The period from 2015 to 2020 of Xinjiang Uygur Autonomous Region People 's Hospital and Xinjiang Military Region General Hospital 's antibiotic release system using polymethyl methacrylate(PMMA)as the carrier and antibiotic release system using medical calcium sulfate(CSC)as the carrier was collected.Thirty-five patients with chronic traumatic osteomyelitis of the tibia treated with bone transfer technology were all male,including 5 patients with postoperative infection and 30 patients with open fracture.The average age of patients treated with polymethylmethacrylate(PMMA)-based antibiotic release system was: 34.44 years old 11.11 years old;the average age of patients treated with medical calcium sulfate(CSC)-based antibiotic release system was 37.47 Aged 10.47 years;18 patients treated with polymethyl methacrylate(PMMA)as an antibiotic release system and 17 patients treated with calcium sulfate(CSC)as an antibiotic release system;all patients in the course of the disease All patients were treated with sensitive antibiotics before surgery.The two groups of patients followed a standardized surgical procedure.The two groups of patients were first treated with a circular external fixation combined with bone transfer technology,and then the infected necrotic soft tissue and necrotic bone tissue were completely removed during the operation.After debridement in both groups,polymethylmethacrylate(PMMA)-based antibiotic release system and calcium sulfate(CSC)-based antibiotic release system wereused to fill the bone defect,and polymethacrylic acid was used.The range of bone defects in patients with methyl ester(PMMA)is: 7cm ± 1.61cm;the use of medical calcium sulfate(CSC)is The range of bone defects in patients with the carrier's antibiotic release system is: 7.29 cm ±1.64 cm.The two groups of patients were compared with relevant data such as infection indicators,number of relapses,operation time,operation cost,number of operations,and length of hospitalization.All the data obtained were analyzed using SPSS 24.0.Results: The medical records of 35 patients were complete and they could be followed up.The follow-up time ranged from 18 to 40 months,with an average of 26.9months.There was no significant difference in the age composition and bone defect length between the two groups.There were no significant differences in postoperative infection indicators,number of relapses,operation time,and number of operations between the two groups of patients.There were statistically significant differences in surgical costs and length of stay between the two groups of patients.Conclusion: The two antibiotic release carriers have their own advantages.The calcium sulfate-based antibiotic release system has a stable release curve,can be absorbed in bone defects,and does not need to be taken out again.The physical properties of calcium sulfate can promote osteogenesis.However,its disadvantages are also obvious.Because of its poor physical stability,it cannot provide reliable stability at the bone defect end.The polymethyl methacrylate-based antibiotic release system has the advantage that it can provide reliable stability at the bone defect end because of its good physical stability.However,its disadvantage is also obvious,because it cannot be absorbed by the tissue and needs to be taken out again.Its release mode is explosive.When the internal antibiotics are released,fibrous tissue can be formed around it to affect the soft tissue healing.Both groups of antibiotics have advantages and disadvantages.It is necessary to comprehensively analyze the pros and cons of the patient's condition and economic conditions to select the best antibiotic carrier.The development of new modified antibiotic bone cement carriers that take into account histocompatibility and physical stability is a new direction in the future.