[Intramedullary boring in infected intramedullary nail osteosyntheses of the tibia and femur].
The infection after intramedullary nailing is a severe complication, which is hard to eradicate. The results of reaming the intramedullary canal after removal of the infected nail were evaluated in our investigation. From 1984 to 1991 fifty-five patients with infected intramedullary nails of the lower extremity were included in this trial. Twenty-one patients had an infection of the femur. Thirty-four patients had a primary infection of the nail, twenty-one patients had multiple operations with periods of infection prior to nailing. All patients had signs of a chronic osteitis and sinus formation. At the time of the follow-up the success of the procedure was evaluated regarding recurrence of infection, range of motion of the extremity and patient comfort. The mean time of observation was 10.1 +/- 4.9 years. All patients with initially infected intramedullary nails had no recurrence of the infection, compared to 62% of those with multiple operations prior to nailing. At the time of the follow up all fractures had healed. 85% of the patients performed full weight bearing. 32 patients (91%) had good or excellent ROM of the adjacent joints.


CONCLUSIONS
Intramedullary reaming after infected nails is a successful procedure and results in infect healing in the majority of patients.
Berufsgenossenschaftliche Kliniken Bergmannsheil, Chirurgische Universitätsklinik und Poliklinik Bochum.
A
A
Pommer
A
A
Dávid
J
J
Richter
G
G
Muhr
D000328:Adult; D005260:Female; D005264:Femoral Fractures / Q000000981:diagnostic imaging / Q000601:surgery*; D005500:Follow-Up Studies; D005594:Fracture Fixation, Intramedullary / Q000295:instrumentation*; D017102:Fracture Healing / Q000502:physiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D011859:Radiography; D012086:Reoperation; D013530:Surgical Wound Infection / Q000000981:diagnostic imaging / Q000601:surgery*; D013978:Tibial Fractures / Q000000981:diagnostic imaging / Q000601:surgery*
Die Markraumbohrung bei infizierten Marknagelosteosynthesen an Tibia und Femur.