DSpace Fukushima Medical University

福島県立医科大学学術成果リポジトリ = Fukushima Medical University Repository >
福島医学会 = The Fukushima Society of Medical Science >
Fukushima Journal of Medical Science >
Vol.61 (2015) >

Please use this identifier to cite or link to this item: http://ir.fmu.ac.jp/dspace/handle/123456789/492

Files in This Item:

File Description SizeFormat
FksmJMedSci_61_p141.pdf1.11 MBAdobe PDFDownload
Title: Surgical treatment for infected long bone defects after limb-threatening trauma: application of locked plate and autogenous cancellous bone graft
Authors: Kawakami, Ryoichi
Konno, Shin-Ichi
Ejiri, Soichi
Hatashita, Satoshi
Affiliation: 整形外科学講座
Source title: Fukushima Journal of Medical Science
Volume: 61
Issue: 2
Start page: 141
End page: 148
Issue Date: 2015
Abstract: Background: Treatment strategies for bone defects include free bone grafting, distraction osteogenesis, and vascularized bone grafting. Because bone defect morphology is often irregular, selecting treatment strategies may be difficult. With the Masquelet technique, a fracture site is bridged and fixed with a locking plate after treating deep infection with antibiotic-containing cement, and a free cancellous bone-graft is concomitantly placed into the defects. This procedure avoids excessive bone resection. Methods: We studied 6 patients who underwent surgical treatment for deep infection occurring after extremity trauma (2004 through 2009). Ages at surgery ranged from 29 to 59 years (largest age group: 30 s). Mean follow-up was 50.7 months (minimum/maximum: 36/72 months). One patient had complete amputation of the upper extremity, 3 open forearm fractures, 1 closed supracondylar femur fracture, and 1 open tibia fracture. In all patients, bone defects were filled with antibiotic-containing cement beads after infected site debridement. If bacterial culture of infected sites during curettage was positive, surgery was repeated to refill bone defects with antibiotic-containing cement beads. After confirmation of negative bacterial culture, osteosynthesis was performed, in which bone defects were bridged and fixed with locking plates. Concomitantly, crushed cancellous bone grafts harvested from the autogenous ilium was placed in the bone defects. Results: Time from bone grafting and plate fixation to bone union was at least 3 and at most 6 months, 4 months on average. Infection relapsed in one patient with methicillin-resistant Staphylococcus aureus, necessitating vascularized fibular grafting which achieved bone union. No patients showed implant loosening or breakage or infection relapse after the last surgery during follow-up. Conclusion: The advantage of cancellous bone grafting include applicability to relatively large bone defects, simple surgical procedure, bone graft adjustability to bone defect morphology, rapid bone graft revascularization resulting in high resistance to infection, and excellent osteogenesis.
Publisher: The Fukushima Society of Medical Science
Publisher (Alternative foam): 福島医学会
language: eng
URI: http://ir.fmu.ac.jp/dspace/handle/123456789/492
Full text URL: http://ir.fmu.ac.jp/dspace/bitstream/123456789/492/1/FksmJMedSci_61_p141.pdf
ISSN: 0016-2590
DOI: 10.5387/fms.2015-17
PubMed ID: 26377029
Related Page: http://doi.org/10.5387/fms.2015-17
Rights: © 2015 The Fukushima Society of Medical Science
Appears in Collections:Vol.61 (2015)

Files in This Item:

File Description SizeFormat
FksmJMedSci_61_p141.pdf1.11 MBAdobe PDFDownload

Items in DSpace are protected by copyright, with all rights reserved, unless otherwise indicated.


DSpace Software Copyright © 2002-2007 MIT and Hewlett-Packard