The Ilizarov fixator and polymethylmethacrylate-antibiotic beads for the treatment of infected deformities.
Eighteen of the 124 patients enrolled in the gentamicin methylmethacrylate bead (GMB; Septopal) study had infected deformities that were treated with the Ilizarov external fixator. Nine of these patients (Group 1) were treated with an initial debridement and intravenous antibiotics for four weeks. Nine patients (Group 2) were treated with GMB and, five days after operation, intravenous antibiotics. The two groups were similar. Group 1 included eight men and one woman (average age, 31.8 years) and Group 2, seven men and two woman (average age, 37.4 years). Both groups had multiple deformities, including nonunions, segmental defects, angulation, and shortness. The end results were identical. Eight patients in each group had their infection successfully arrested (88.9%), and eight patients in each group had their deformity successfully treated. The use of GMB with the Ilizarov fixator was as effective as long-term parenteral antibiotics with the Ilizarov fixator for the treatment of infected deformities.
Calhoun
J H
JH
Division of Orthopaedic Surgery, University of Texas Medical Branch, Galveston 77550.
Anger
D M
DM
Ledbetter
B R
BR
Cobos
J A
JA
Mader
J T
JT
D000328:Adult; D002908:Chronic Disease; D003131:Combined Modality Therapy; D003646:Debridement; D004359:Drug Therapy, Combination / Q000627:therapeutic use*; D016267:External Fixators; D005260:Female; D005597:Fractures, Open / Q000150:complications / Q000601:surgery; D005839:Gentamicins / Q000627:therapeutic use*; D006801:Humans; D008297:Male; D008768:Methylmethacrylates / Q000627:therapeutic use*; D008875:Middle Aged; D010019:Osteomyelitis / Q000188:drug therapy* / Q000209:etiology / Q000601:surgery; D011183:Postoperative Complications; D012086:Reoperation
D005839:Gentamicins; D008768:Methylmethacrylates; C030159:gentamicin-polymethylmethacrylate bead