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Kang Y, Wu Y, Ma Y, Jia X, Zhang M, Zhou M, Lin F, Rui Y. A novel primary antibiotic cement-coated locking plate as a temporary fixation for the treatment of open tibial fracture. Sci Rep 2023; 13:21890. [PMID: 38082020 PMCID: PMC10713602 DOI: 10.1038/s41598-023-49460-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2023] [Accepted: 12/08/2023] [Indexed: 12/18/2023] Open
Abstract
Complex lower extremity trauma reconstruction remains a challenge. This study used an internal fixation composite structure of antibiotic cement plates as a temporary fixation to treat lower extremity Grade III open fractures; thus, reducing the treatment period and complications of external fixation. We aimed to assess the safety and efficacy of this technique in the initial surgery stage. Between January 2018 and March 2021, 20 patients with Gustilo grade IIIB/C open fractures received an antibiotic cement-coated locking plate as a temporary internal fixator during initial surgery. Thorough debridement and temporary internal fixation were performed with a 3.5-mm system antibiotic cement-coated locking plate. Ten patients required free bone fragment removal, followed by bone cement packing. The final stage involved internal fixation and wound repair with a free anterolateral thigh flap. Clinical and imaging results were retrospectively analysed. The repair time ranged 1-7 days. All flaps survived. Two patients experienced wound infection, and one developed severe bone infection 3 months after three-stage bone graft surgery. Autologous cancellous bone grafting was performed on 10 patients with bone defects 6 weeks after surgery. Bone union was universally achieved after 1 year. This method proved safe and effective, successfully repairing Grade III open fractures of the lower extremity 1-7 days post-treatment.
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Affiliation(s)
- Yongqiang Kang
- Medical College, Soochow University, Suzhou, Jiangsu, China
| | - Yongwei Wu
- Department of Traumatic Orthopedics, Wuxi Ninth People's Hospital Affiliated to Soochow University, Liangxi Road, No.999, Binhu District, Wuxi, Jiangsu, China
| | - Yunhong Ma
- Department of Traumatic Orthopedics, Wuxi Ninth People's Hospital Affiliated to Soochow University, Liangxi Road, No.999, Binhu District, Wuxi, Jiangsu, China
| | - Xueyuan Jia
- Department of Traumatic Orthopedics, Wuxi Ninth People's Hospital Affiliated to Soochow University, Liangxi Road, No.999, Binhu District, Wuxi, Jiangsu, China
| | - Mingyu Zhang
- Department of Traumatic Orthopedics, Wuxi Ninth People's Hospital Affiliated to Soochow University, Liangxi Road, No.999, Binhu District, Wuxi, Jiangsu, China
| | - Ming Zhou
- Department of Traumatic Orthopedics, Wuxi Ninth People's Hospital Affiliated to Soochow University, Liangxi Road, No.999, Binhu District, Wuxi, Jiangsu, China
| | - Fang Lin
- Department of Traumatic Orthopedics, Wuxi Ninth People's Hospital Affiliated to Soochow University, Liangxi Road, No.999, Binhu District, Wuxi, Jiangsu, China
| | - Yongjun Rui
- Department of Traumatic Orthopedics, Wuxi Ninth People's Hospital Affiliated to Soochow University, Liangxi Road, No.999, Binhu District, Wuxi, Jiangsu, China.
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