Journal of AdvancedMedical and Dental Sciences Research

Background:Nonunion of long bones with infection poses a persistent and incapacitating challenge. Managing such cases involves addressing issues of infection, instability, and deformity. Conventionally, a two-stage approach is employed, tackling infection initially and subsequently addressing the nonunion. Methods:A cohort of 30 patients, all aged 18 years and above, presenting with infected non-union of the femur and tibia, underwent surgical intervention involving the application of an antibiotic cement-coated intramedullary nail (ILN). The preparation of the antibiotic cement nail utilized the endotracheal tube method, with vancomycin administered at a dosage of 4 mg. The assessment of functional outcomes focused on the effectiveness in controlling infection, achieving bony union, and monitoring any associated complications.Results:In 80% of the patients, infection was successfully controlled. Over an average follow-up period of 12 months, bony union was attained in 20 out of 30 patients (66%) using antibiotic cement nailing as the sole procedure, with an average union time of 32 weeks. The remaining 10 patients necessitated additional interventions such as bone grafting or exchange nailing; these procedures were performed in 4 patients, resulting in fracture union. Recurrence of infection was observed in 4 cases. Complications included challenges in nail removal in 4 cases, a broken nail in 2 cases, and a bent nail in 2 cases.Conclusion:The utilization of antibiotic cement-impregnated nailing emerges as a straightforward, cost-effective, and efficacious single-stage procedure for managing infected nonunion of long bones. This approach boasts improved patient compliance and is characterized by its simplicity. The required instruments are readily available, making it a feasible procedure that can be performed at any orthopediccenter.