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The use of solid form-fitting antibiotic cement spacers in bone loss of the lower extremity

Publication ,  Journal Article
Richard, MJ; Creevy, WR; Tornetta, P
Published in: Current Orthopaedic Practice
October 11, 2012

Background: The purpose of this study was to report on the ease and success of using a solid form-fitting antibiotic cement spacer to manage critical-sized bone defects of the lower extremity. Our hypothesis was that these form fitting spacers will prevent the involution of structures at risk and allow for easy access to the bone defect for secondary bone grafting. Furthermore, antibiotic cement spacers have been demonstrated to form an induced membrane supportive of healing for subsequent bone grafting. Methods: Nineteen patients with tibial shaft fractures and two patients with distal femoral fractures with critical-sized bone defects were treated using solid form-fitting antibiotic cement spacers. At the time of definitive closure, a solid form-fitting antibiotic cement spacer was used to fill the defect. After maturity of the coverage, the spacers were removed and replaced with bone graft or bone graft substitute. Results: The average defect size was 4cm (2-16cm) and a minimum of 50% of the cortical circumference. The average time to bone grafting was 11 weeks (6-31 weeks). In all patients, a pseudocapsule had formed over the spacer making exposure extremely easy. The spacers prevented involution of muscle, nerves, and vascular structures in all patients. Conclusions: The use of a solid form-fitting antibiotic cement spacer to prevent involution of muscle and neurovascular structures to defects eased bone-grafting procedures and is recommended. No soft-tissue coverage difficulties occurred after extensive grafting. The pseudocapsule facilitated secondary bone grafting, and all defects treated with autogenous cancellous graft healed. © 2012 Wolters Kluwer Health.

Duke Scholars

Published In

Current Orthopaedic Practice

DOI

EISSN

1941-7551

ISSN

1940-7041

Publication Date

October 11, 2012

Volume

23

Issue

5

Start / End Page

453 / 458
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Richard, M. J., Creevy, W. R., & Tornetta, P. (2012). The use of solid form-fitting antibiotic cement spacers in bone loss of the lower extremity. Current Orthopaedic Practice, 23(5), 453–458. https://doi.org/10.1097/BCO.0b013e3182648c20
Richard, M. J., W. R. Creevy, and P. Tornetta. “The use of solid form-fitting antibiotic cement spacers in bone loss of the lower extremity.” Current Orthopaedic Practice 23, no. 5 (October 11, 2012): 453–58. https://doi.org/10.1097/BCO.0b013e3182648c20.
Richard MJ, Creevy WR, Tornetta P. The use of solid form-fitting antibiotic cement spacers in bone loss of the lower extremity. Current Orthopaedic Practice. 2012 Oct 11;23(5):453–8.
Richard, M. J., et al. “The use of solid form-fitting antibiotic cement spacers in bone loss of the lower extremity.” Current Orthopaedic Practice, vol. 23, no. 5, Oct. 2012, pp. 453–58. Scopus, doi:10.1097/BCO.0b013e3182648c20.
Richard MJ, Creevy WR, Tornetta P. The use of solid form-fitting antibiotic cement spacers in bone loss of the lower extremity. Current Orthopaedic Practice. 2012 Oct 11;23(5):453–458.

Published In

Current Orthopaedic Practice

DOI

EISSN

1941-7551

ISSN

1940-7041

Publication Date

October 11, 2012

Volume

23

Issue

5

Start / End Page

453 / 458