[Application of gentamycini impregnated polymethylmethacrylate (PMMA) (Septopal) in treatment of infected nonunion. Own experiments].
BACKGROUND
Treatment techniques of osteomyelitis and infected nonunion require local antibiotic-therapy in the infection places because of the necessity of achievement of a very high concentration of antibiotic. Among the methods of local application of antibiotic we have the possibility of non-absorbale carriers application where polymethylmethacrylate (PMMA) is the carrier. Aminoglycosides are the most commonly employed antibiotics for use with PMMA.


OBJECTIVE
Estimation of the possibility of use gentamycini-impregnated polymethylmethacrylate (PMMA) (Septopal) in treatment of infected nonunion.


METHODS
In the years 2001-2006 in Clinic of Traumatology and Hand Surgery in Wrocław Medical University, 16 patients were treated because of osteomyelitis and infected nonunion of the long bone. Osteomeylitis, according to the Cierny-Mader's classification, was determined as type IVA in 8 patients, as type IIIA in 4 patients, as type IVB in 4 patients. In stage I surgical cleaning focus of the infected nonunion, external stabilization and implantation of PMMA with gentamycyni were performed, in stage II bone graft with length from 2 to 5 cm was applied.


RESULTS
Eradication of the inflammatory process was achieved 13 patients, bone union-in 12 patients. The mean time of bone union achievement was 9 months. The failures concerned mainly patients with type IVB of osteomyelitis according to Cierny-Mader's classification.


CONCLUSIONS
Application of PMMA with gentamycini is an efficient method in the treatment of traumatic osteomyelitis. The reults of osteomyelitis treatment correspond to the osteomyelitis classification according to Cierny-Mader. Application of PMMA with gentamycyni in connection with surgery of nonunion prevents possible infection and creates the space for bone grafts.
Katedra i Klinika Chirurgii Urazowej i Chirurgii Reki Akademii Medycznej we Wrocławiu. preichert@wp.pl
Paweł
P
Reichert
Roman
R
Rutowski
Krzysztof
K
Zimmer
Jerzy
J
Gosk
D000293:Adolescent; D000328:Adult; D000890:Anti-Infective Agents / Q000008:administration & dosage*; D001843:Bone Cements / Q000494:pharmacology*; D005260:Female; D005599:Fractures, Ununited / Q000188:drug therapy*; D005839:Gentamicins / Q000008:administration & dosage*; D006801:Humans; D008297:Male; D008768:Methylmethacrylates / Q000008:administration & dosage*; D008875:Middle Aged; D010019:Osteomyelitis / Q000188:drug therapy*; D011542:Pseudarthrosis / Q000188:drug therapy* / Q000382:microbiology; D016896:Treatment Outcome
D000890:Anti-Infective Agents; D001843:Bone Cements; D005839:Gentamicins; D008768:Methylmethacrylates; C030159:gentamicin-polymethylmethacrylate bead