ROLE OF ANTIBIOTIC BEADS IN MANAGEMENT OF COMPOUND FRACTURE LONG BONES
DOI:
https://doi.org/10.22159/ajpcr.2023.v16i3.46666Keywords:
Antibiotic beads, Compound fracture, Long bonesAbstract
Objective: The aim of the study was to assess role of antibiotic beads in the management of compound fracture long bone.
Methods: Twenty-four patients with compound long bone fracture (Grade II, IIIA, and IIIB) operated with initial debridement, fracture stabilization, and antibiotic coated beads. All patients were followed-up till at least 6 months. All patients were evaluated clinically and radiologically for functional outcome.
Results: Seventeen patients (71%) were male while 7 patients (29%) were female. Mean age at the time of surgery was 34.5 years (Range: 20– 70 years). Sixteen patients had fracture on the right side while the eight patients had on the left side. Sixteen patients had Type II compound injury (67%), five patients had Type IIIA (21%), and three patients had Type IIIB compound injury (12%). The average time of union was 16 weeks in 6 patients (26.06%), 12–14 weeks in 8 patients (34.78%) and 18–22 weeks in 9 patients (39.14%). Out of 24 cases, only one case had superficial infection, one case has deep infection, three patients had raw skin area, one patient developed post-operative knee stiffness, and another had 1 cm limb shortening. Functional outcome is seen as six patients with excellent outcome, eight patients with fair outcome, nine patients with good outcome, and one patient had poor outcome.
Conclusion: The study concludes the use of antibiotic coated beads in compound fracture significantly reduces the infection in compound fracture of Grade II, Grade IIIA, and IIIB. Antibiotic impregnated beads delivers higher concentration of local antibiotics to wound site which helps in hastening recovery of wound. This reduces hospital stay and morbidity.
Downloads
References
Morris R, Jones NC, Pallister I. The use of personalised patient information leaflets to improve patients’ perceived understanding following open fractures. Eur J Orthop Surg Traumatol 2019;29:537- 43. doi: 10.1007/s00590-018-2332-6, PMID 30368617
Mebert RV, Klukowska-Roetzler J, Ziegenhorn S, Exadaktylos AK. Push scooter-related injuries ic’n adults: An underestimated threat? Two decades analysed by an emergency department in the capital of Switzerland. BMJ Open Sport Exerc Med 2018;4:e000428. doi: 10.1136/bmjsem-2018-000428, PMID 30364432
Court-Brown CM, McQueen MM, Quaba AA. Management of Open Fractures. St. Louis; London: Mosby; M Dunitz; 1996.
Roberts CS, Pape HC, Jones AL, Malkani AL, Rodriguez JL, Giannoudis PV. Damage control orthopaedics: Evolving concepts in the treatment of patients who have sustained orthopaedic trauma. Instr Course Lect 2005;54:447-62. doi: 10.2106/00004623-200502000- 00030, PMID 15948472
Frigg R. Development of the locking compression plate. Injury 2003;34:B6-10. doi: 10.1016/j.injury.2003.09.020, PMID 14580981
Wininger DA, Fass RJ. Antibiotic-impregnated cement and beads for orthopaedic infections. Antimicrob Agents Chemother 1996;40:2675-9. doi: 10.1128/AAC.40.12.2675, PMID 9124821
Henry SL, Ostermann PH, Seligson D. The antibiotic bead pouch technique. The management of severe compound fractures. Clin Orthop Relat Res 1993;295:54-62.
Amarnath S, Madhuri KB, Tejaswi L. Brahma AC, Ali SF. Antibiotic bead pouches in open fractures: Elution of antibiotics from PMMA bead pouches in open fractures. IOSR J Pharm Biol Sci 2018;13:20-30.
Published
How to Cite
Issue
Section
Copyright (c) 2022 Dr. Mohit kumar, Dr. Sachin Pachori, Dr. Laxman Choudhary, Dr. Chetan Mehra
This work is licensed under a Creative Commons Attribution 4.0 International License.
The publication is licensed under CC By and is open access. Copyright is with author and allowed to retain publishing rights without restrictions.