This journal is
indexed in Scopus
Year 2020 Vol. 28 No 6
TRAUMATOLOGY AND ORTHOPEDICS
P.A. VOLOTOVSKI 1, À.À. SITNIK 1, D.V. TAPALSKI 2, Ì.À. YARMOLENKO 3, Î.À. KORZUN 1, O.N. BONDAREV 1, Ì.À. GERASIMENKO 1
CLINICAL APPLICATION OF IMMEDIATE RESULTS OF CLOSED INTRAMEDULLARY NAILING WITH THREE-COMPONENT ANTIBACTERIAL COATING IN INFECTED FRACTURES AND NONUNION OF LONG TUBULAR BONES
Republican Research and Practical Center of Traumatology and Orthopedics 1, Minsk,
Gomel State Medical University 2,
Francisk Skorina Gomel State University 3, Gomel,
The Republic of Belarus
Objective. The prospective study was performed to evaluate the efficacy and safety of osteosynthesis by closed intramedullary nailing with antibacterial coating in infected fractures and nonunions of the lower extremity long tubular bones.
Methods. The study included patients (n=8) with infected fractures and nonunions of the tibia and femur. Solid titanium nails (with holes for blocking ) were used as implants. Plasma spray coating method (from the active gas phase) was used for the required thickness coating. The technique of surgical intervention included two main components: debridement of the infection site and the insertion of the nail into the medullary canal. After surgery, all patients received antibiotics based on the microbiological study. Follow-up visits to assess the activity of the infectious process and the degree of consolidation were scheduled in 6, 12, 24 and 52 weeks.
Results. By the time of preparing this article, the mean follow-up for patients after surgery had been 4.4 ± 1.0 months. None of the patients showed any signs of infection recurrence after surgery and completion of the course of antibiotic therapy, which indicates the effectiveness and safety of this technique. Not later than 2.5 months after the surgery, all 8 (100%) patients started full weight-bearing on the operated limb. Radiography confirmed the bone healing in 5 patients; in 3 patients X-ray shows the initial signs of fracture consolidation.
Conclusion. Intramedullary osteosynthesis with new three-component antibacterial coating allowed eradicating the infection and achieving bone healing in patients with infected fractures and non-unions of the tibia and femur. This technique is effective and its application is not associated with difficulties typical for the intraoperative preparation of antibacterial coatings.
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220024, Republic of Belarus,
Minsk, Leytenant Kizhevatov Str., 60-4,
Republican Research and Practical Center
of Traumatology and Orthopedics
tel. +375 17 373-59-93,
Volotovski Pavel A.
Volotovski Pavel A., PhD, Academic Secretary, Republican Research and Practical Center of Traumatology and Orthopedics, Minsk, Republic of Belarus
Sitnik Alexander A., PhD, Associate Professor, Head of the Laboratory of Adult Traumatology, Republican Research and Practical Center of Traumatology and Orthopedics, Minsk, Republic of Belarus
Tapalski Dzmitry V., PhD, Associate Professor, Head of the Department of Microbiology, Virology and Immunology, Gomel State Medical University, Gomel, Republic of Belarus
Yarmolenko Maxim A., DSñTech, Associate Professor, the Department of Radiophysics and Electronics, Francisk Skorina Gomel State University, Gomel, Republic of Belarus
Korzun Oleg A., PhD, Leading Researcher, Republican Research and Practical Center of Traumatology and Orthopedics, Minsk, Republic of Belarus
Bondarev Oleg N., PhD, Researcher, Republican Research and Practical Center of Traumatology and Orthopedics, Minsk, Republic of Belarus
Gerasimenko Mikhail A., MD, Professor, Head of the Republican Research and Practical Center of Traumatology and Orthopedics, Minsk, Republic of Belarus