title: An improved technique for removing intramedullary antibiotic beads in osteomyelitis of the tibial shaft.
abstract: BACKGROUND
  The intramedullary insertion of antibiotic-impregnated cement beads is used widely for the treatment of intramedullary infection. This report describes an improved technique for removing chains of antibiotic beads inserted into the intramedullary cavity.
  
  
  METHODS
  We examined four cases in three patients of the intramedullary insertion of chains of antibiotic-impregnated cement beads for the treatment of osteomyelitis of the diaphysis of the tibia after the fixation of fractures with interlocking nails. During bead removal, the tip of an intramedullary guidewire was bent into a hook shape and was then engaged with the chain of impacted beads. The guidewire was removed from the intramedullary cavity, permitting the extraction of any beads adhering to the wire.
  
  
  RESULTS
  As beads came into contact with the tip of the intramedullary guidewire, they could be extracted easily. No additional incision or bone fenestration was required.
  
  
  CONCLUSIONS
  The use of a hook-shaped intramedullary guidewire simplifies the removal of chains of antibiotic-impregnated cement beads without the need for an invasive procedure. This technique makes the use of chains of cement beads a favorable choice for treating intramedullary infection.
authors.affiliation: Department of Orthopedic Surgery, College of Medicine, Chung-Ang University , Seoul, Korea.
authors.forename: Han-Jun
authors.initials: HJ
authors.lastname: Lee
authors.forename: Gang-Un
authors.initials: GU
authors.lastname: Kim
authors.forename: Soo Yong
authors.initials: SY
authors.lastname: Kang
authors.forename: Jae-Sung
authors.initials: JS
authors.lastname: Lee
authors.forename: Ho-Joong
authors.initials: HJ
authors.lastname: Jung
mesh_terms: D000328:Adult; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D001843:Bone Cements / Q000627:therapeutic use*; D005547:Foreign Bodies / Q000601:surgery*; D006801:Humans; D008875:Middle Aged; D010019:Osteomyelitis / Q000188:drug therapy*; D013977:Tibia / Q000601:surgery*; D055815:Young Adult
chemical_list: D000900:Anti-Bacterial Agents; D001843:Bone Cements