Temporary antibiotic cement-covered gamma nail spacer for an infected nonunion of the proximal femur.
We report the case of an infected nonunion of the proximal femoral in an elderly patient. There was extensive involvement of the entire proximal femur precluding salvage. An impromptu use of a cephalomedullary nail coated with antibiotic-laden bone cement is described, followed by reimplantation with a revision-type proximal femoral prosthesis. The patient had resection of the proximal femur, placement of a temporary functional spacer, and reimplantation after a course of antibiotics, with good success. The method we describe is a reasonable alternative when standard off-the-shelf systems or other methods of temporary spacer creation are not available.
Rodriguez
Hugo
H
University San José del Rosario, Bogotá, Colombia.
Ziran
Bruce H
BH
D000368:Aged; D000900:Anti-Bacterial Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D001424:Bacterial Infections / Q000188:drug therapy / Q000209:etiology; D001843:Bone Cements; D016503:Drug Delivery Systems; D005260:Female; D006620:Hip Fractures / Q000382:microbiology / Q000601:surgery*; D006801:Humans; D009984:Orthopedic Fixation Devices / Q000382:microbiology; D019637:Orthopedic Procedures / Q000295:instrumentation* / Q000379:methods; D016459:Prosthesis-Related Infections / Q000188:drug therapy*; D014031:Tobramycin / Q000008:administration & dosage / Q000627:therapeutic use*; D014640:Vancomycin / Q000008:administration & dosage / Q000627:therapeutic use*
D000900:Anti-Bacterial Agents; D001843:Bone Cements; D014640:Vancomycin; D014031:Tobramycin