Efficacy of Infection Eradication in Antibiotic Cement-Coated Intramedullary Nails for Fracture-Related Infections, Nonunions, and Fusions

Conway, Janet D.; Elhessy, Ahmed H.; Galiboglu, Selin; Patel, Nirav; Gesheff, Martin G.

doi:10.3390/antibiotics11060709

Open AccessArticle

Efficacy of Infection Eradication in Antibiotic Cement-Coated Intramedullary Nails for Fracture-Related Infections, Nonunions, and Fusions

by

Janet D. Conway

^*,

Ahmed H. Elhessy

,

Selin Galiboglu

,

Nirav Patel

and

Martin G. Gesheff

International Center for Limb Lengthening, Rubin Institute for Advanced Orthopedics, Sinai Hospital of Baltimore, Baltimore, MD 21215, USA

^*

Author to whom correspondence should be addressed.

Antibiotics 2022, 11(6), 709; https://doi.org/10.3390/antibiotics11060709

Submission received: 25 March 2022 / Revised: 16 May 2022 / Accepted: 20 May 2022 / Published: 25 May 2022

(This article belongs to the Special Issue Fracture-Related Infection: An Update on Antimicrobial Therapy)

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Abstract

Antibiotic cement-coated intramedullary nails (ACCINs) are increasing in popularity as a viable solution for the treatment of fracture-related infections (FRIs), infected long bone nonunions, and arthrodeses without an external fixator. ACCINs effectively manage to fulfill three of the basic principles for eradicating osteomyelitis: dead space management, antibiotic delivery, and bone stability. We performed a retrospective review of 111 patients who were treated with ACCINs between January 2014 and December 2020. In our series, 87.4% (n = 97) of patients achieved healed and uninfected bone or stable arthrodesis at a mean follow-up of 29.2 months (range, 6–93 months). Additionally, 69.1% (n = 67) of healed patients were resolved after only one procedure, and the remainder (30.9%, n = 30) healed after one or more additional procedures. The mean number of additional procedures was 2.1 (range, 1–6 additional procedures). The overall limb salvage rate was 93.7% (n = 104). The majority of the total cohort were successfully treated in only one surgery. This study suggests that ACCINs are effective in the treatment of FRIs, infected long bone nonunions, and infected ankle and knee arthrodeses.

Keywords: antibiotic cement-coated intramedullary nails; ACCIN; FRI; osteomyelitis; infected arthrodesis; infected fusion; infected nonunion

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MDPI and ACS Style

Conway, J.D.; Elhessy, A.H.; Galiboglu, S.; Patel, N.; Gesheff, M.G. Efficacy of Infection Eradication in Antibiotic Cement-Coated Intramedullary Nails for Fracture-Related Infections, Nonunions, and Fusions. Antibiotics 2022, 11, 709. https://doi.org/10.3390/antibiotics11060709

AMA Style

Conway JD, Elhessy AH, Galiboglu S, Patel N, Gesheff MG. Efficacy of Infection Eradication in Antibiotic Cement-Coated Intramedullary Nails for Fracture-Related Infections, Nonunions, and Fusions. Antibiotics. 2022; 11(6):709. https://doi.org/10.3390/antibiotics11060709

Chicago/Turabian Style

Conway, Janet D., Ahmed H. Elhessy, Selin Galiboglu, Nirav Patel, and Martin G. Gesheff. 2022. "Efficacy of Infection Eradication in Antibiotic Cement-Coated Intramedullary Nails for Fracture-Related Infections, Nonunions, and Fusions" Antibiotics 11, no. 6: 709. https://doi.org/10.3390/antibiotics11060709

APA Style

Conway, J. D., Elhessy, A. H., Galiboglu, S., Patel, N., & Gesheff, M. G. (2022). Efficacy of Infection Eradication in Antibiotic Cement-Coated Intramedullary Nails for Fracture-Related Infections, Nonunions, and Fusions. Antibiotics, 11(6), 709. https://doi.org/10.3390/antibiotics11060709

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Efficacy of Infection Eradication in Antibiotic Cement-Coated Intramedullary Nails for Fracture-Related Infections, Nonunions, and Fusions

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