title: Antibiotic-coated intramedullary rod.
abstract: Surgical reconstruction for limb salvage is an acceptable and often preferred treatment for patients who are facing potential amputation. Because of the invasive nature of these surgeries, complications such as infection are not uncommon. Osseous infection at the site of implantable hardware may result in a tremendous consequence to the patient. In an attempt to minimize infection with implantable hardware, a local delivery system involving the use of antimicrobial coating on medical devices has been developed. This system optimizes local administration of antibiotics to the sources of infection enabling continuation of limb salvage versus amputation. The authors describe the fabrication of an antibiotic impregnated polymethylmethacrylate (PMMA) intramedullary rod that is used to replace an infected intramedullary nail of the tibia after reconstruction surgery. The benefits of the rod include increased surface area for local delivery of antibiotics, concurrent stabilization of the surgical site, occupancy of the dead space, and ease of removal after eradication of infection.
authors.affiliation: Department of Foot and Ankle Surgery, The Western Pennsylvania Hospital, Pittsburgh, USA. rwmendicino@faiwp.com
authors.forename: Robert W
authors.initials: RW
authors.lastname: Mendicino
authors.forename: Cody A
authors.initials: CA
authors.lastname: Bowers
authors.forename: Alan R
authors.initials: AR
authors.lastname: Catanzariti
mesh_terms: D000328:Adult; D000843:Ankle Joint / Q000601:surgery; D000900:Anti-Bacterial Agents / Q000008:administration & dosage*; D001177:Arthropathy, Neurogenic / Q000601:surgery*; D001858:Bone Nails; D020099:Coated Materials, Biocompatible; D020878:Device Removal; D016503:Drug Delivery Systems; D005534:Foot Diseases / Q000601:surgery; D005594:Fracture Fixation, Intramedullary / Q000009:adverse effects / Q000295:instrumentation*; D006801:Humans; D023821:Limb Salvage; D008297:Male; D019904:Polymethyl Methacrylate; D019736:Prostheses and Implants; D011474:Prosthesis Design; D016459:Prosthesis-Related Infections / Q000517:prevention & control*; D013530:Surgical Wound Infection / Q000517:prevention & control; D013977:Tibia / Q000601:surgery
chemical_list: D000900:Anti-Bacterial Agents; D020099:Coated Materials, Biocompatible; D019904:Polymethyl Methacrylate