title: Temporary antibiotic cement-covered gamma nail spacer for an infected nonunion of the proximal femur.
abstract: 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.
authors.affiliation: University San José del Rosario, Bogotá, Colombia.
authors.forename: Hugo
authors.initials: H
authors.lastname: Rodriguez
authors.forename: Bruce H
authors.initials: BH
authors.lastname: Ziran
mesh_terms: 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*
chemical_list: D000900:Anti-Bacterial Agents; D001843:Bone Cements; D014640:Vancomycin; D014031:Tobramycin