ĐIỀU TRỊ NHIỄM TRÙNG SAU MỔ KẾT HỢP XƯƠNG CHÀY BẰNG ĐINH NỘI TỦY XI MĂNG KHÁNG SINH – BÁO CÁO CA LÂM SÀNG VÀ NHÌN LẠI Y VĂN

Abstract

Objective: Intramedullary nails coated with antibiotic cement (ACCINs) have been utilized in clinical practice for many years and have demonstrated effectiveness in eliminating infection associated with bone fixation, while also providing stable internal fixation to achieve bone healing. We present a technique for coating the intramedullary nail with cement to facilitate bone union, applied at Nhan Dan Gia Dinh Hospital, along with a literature review. We applied this treatment to a case of post-operative infection following tibial diaphysis fixation. Our technique is based on guidelines from existing studies in the medical literature. The patient showed good results in infection eradication and achieved bone healing, while ambulating early and requiring fewer surgical interventions. Case Presentation: A 57-year-old female patient presented to the hospital after experiencing an infection related to an open fracture of the lower third of the tibial shaft, which had been treated with locked plating one month prior. The patient underwent debridement, removal of hardware, and the placement of an external fixator to manage the soft tissue, followed by conversion to bone fixation using an antibiotic cement-coated intramedullary nail. Seven months post-surgery, the patient achieved good bone healing and functional outcomes. Conclusion: The use of antibiotic cement-coated intramedullary nails in the treatment of infection following fixation of tibial shaft fractures is an effective approach. It helps eradicate infection, promotes bone healing, allows early mobilization, and reduces the number of surgical procedures. Our technique involves using an intramedullary nail and a customized mold to create an antibiotic cement-coated nail with the desired diameter.