Objective: To observe and analyse the effect of using antibiotic bone cement in treating patients with traumatic tibial osteomyelitis.
Methods: This study included 45 patients who were diagnosed with chronic traumatic tibial osteomyelitis. All the patients underwent complete debridement and focus clearance in one stage, as well as the insertion of self-made antibiotic bone cement in the focus area. They also underwent wound closure surgery using one stage closure or VSD technique according to the actual condition of the wound. For VSD cases, debridement should be made again after seven to ten days. The VSD, self-made antibiotic bone cement beads should be replaced according to the specific condition of the wound. And the free skin graft and tissue flap transfer plus additional plate fixation measures can be carried out. Then bone grafting can be implemented.
Results: After the treatment, patients’ infection in this study was effectively controlled, and the survival of skin grafts and the elasticity of skin were obtained, what’s more, no recurrence occurred. The wound healing time of patients ranged from 15 d to 160 d, with an average time of 32.8 ± 4.6 d. Through the VAS pain scores before and after surgery, the results showed that postoperative advantage was obviously superior to the preoperative one. Through comparing the ADL scores before and after surgery, the results showed that postoperative effect was obviously better than the preoperative one. All patients were followed up for 6 months to 36 months, and the effect of bony union on the fracture ends was obtained with an average fracture healing time of 8.7 ± 2.6 months.
Conclusion: Relatively satisfactory results can be achieved through using antibiotic bone cement in the treatment of traumatic tibial osteomyelitis. It has high safety and reliability, and is of great value for popularization and application.Author(s): Liying Hou, Hui Shi, Mingming Wang, Jinghua Liu, Wei Zang