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Management of Chronic Osteomyelitis of Shaft of Long Bones with Antibiotic Impregnated Cement Coated Intramedullary Nailing: A Prospective Analysis

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Original Article | Journal of Clinical Orthopaedics | Vol 10 | Issue 2 | July-December 2025 | page: 111-115 | V Sriram, L Sachin Patel, K K Nrupatunga

DOI: https://doi.org/10.13107/jcorth.2025.v10.i02.794

Open Access License: CC BY-NC 4.0
Copyright Statement: Copyright © 2025; The Author(s).

Submitted Date: 01 Aug 2025, Review Date: 21 Sep 2025, Accepted Date: 14 Oct 2025 & Published Date: 10 Dec 2025

Author: V Sriram [1], L Sachin Patel [2], K K Nrupatunga [3]

[1] Department of Orthopaedics, East Point College of Medical Sciences, Bengaluru, Karnataka, India.
[2] Department of Orthopaedics, PES University Institute of Medical Sciences and Research, Bengaluru, Karnataka, India.
[3] Department of Orthopaedics, BGS Medical College Hospital, Bengaluru, Karnataka, India.

Address of Correspondence
Dr. L Sachin Patel,
Department of Orthopaedics, PES University Institute of Medical Sciences and Research, Bengaluru, Karnataka, India.
E-mail: spatel.bl@gmail.com

Abstract

Background/Aim: The aim of this study was to study the outcome of antibiotic impregnated cement coated intramedullay nailing in the management of chronic osteomyelitis of shaft of long bones.
Materials and Methods: In this prospective study, 17 patients admitted in our hospital who were diagnosed with chronic osteomyelitis of long bones and culture-positive infected fractures of long bones were considered in the study and they were evaluated for a period of 12 months.
Results: Bony union was achieved at around 5 months (20 weeks) on average, and duration for control of infection in case of chronic osteomyelitis was around 4 months, complications such as persistent infection and non-union were around 18 % overall.
Conclusion: The main advantage of the antibiotic nail is that both the union and the infection can be addressed at the same surgery. Single-staged antibiotic nailing technique provides good results, lessens the duration of hospital stay, and reduces the morbidity in infected nonunion of long bones with <2 cm defect.
Keywords: Antibiotic impregnated cement-coated intramedullay nailing, Chronic osteomyelitis, Infected non-union, Infection.

References

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How to Cite this Article: Sriram V, Patel SL, Nrupatunga KK. Management of Chronic Osteomyelitis of Shaft of Long Bones with Antibiotic Impregnated Cement Coated Intramedullary Nailing: A Prospective Analysis. Journal of Clinical Orthopaedics. July-December 2025;10(2):111-115.

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A rare case report of chronic osteomyelitis of ulna with global involvement in an infant: A management perspective using Modified Masquelet technique with “Atmanirbhar” Gentamycin beads

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Journal of Clinical Orthopaedics | Vol 5 | Issue 2 |  July-Dec 2020 | page:45-48 | Rajesh Lalchandani, Gaurav Garg, Rakesh Parmar, Rajesh kumar Yadav

Author: Rajesh Lalchandani [1], Gaurav Garg [1], Rakesh Parmar [1], Rajesh kumar Yadav [1]

[1] Department of Orthopedics, P.D. Hinduja National Hospital & MRC, Veer Savarkar Marg, Mahim West, Mumbai – 400016

Address of Correspondence
Dr. Vivek Shetty,
Department of Orthopedics, P.D. Hinduja National Hospital & MRC, Veer Savarkar Marg, Mahim West, Mumbai – 400016
E-mail: vivshetty7777@gmail.com

Abstract

Chronic osteomyelitis treatment has always been a serious challenge for an orthopaedic surgeon to treat and it needs dedication, perseverance and multiple operations for its complete cure. We hereby report a case of a one year female who presented to us with chronic osteomyelitis ulna with global involvement. The case was successful managed by debridement, excision of sequestered ulna and insertion of locally made gentamycin beads mounted on kirschner wire as a cement spacer in the first stage. After 4 weeks, removal of gentamycin beads was done followed by visualization of membrane formation and fibular grafting mounted on a k wire for stabilization. During follow-up, we observed good uptake of the graft at both the ends and regeneration of the fibula at donor site with no signs of recurrence of osteomyelitis. We are reporting this case because of its unique global involvement of ulna and use of modified Masquelet technique using gentamycin beads(rather than a blob of cement) on a wire as cement spacer and also as a tool for local delivery of antibiotics.
Keywords: Chronic Osteomyelitis, Modified Masquelet technique, gentamycin beads, diaphyseal osteomyelitis

References

1. Chadayammuri, Vivek et al. “Innovative strategies for the management of long bone infection: a review of the Masquelet technique.” Patient safety in surgery vol. 9 32. 14 Oct. 2015, doi:10.1186/s13037-015-0079-0
2. Careri, S. & Vitiello, Raffaele & Oliva, M.S. & Ziranu, A. & Maccauro, G. & Perisano, Carlo. (2019). Masquelet technique and osteomyelitis: innovations and literature review. European review for medical and pharmacological sciences. 23. 210-216. 10.26355/eurrev_201904_17495
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4. D. Bettin, H. Böhm, M. Clatworthy, D. Zurakowski, T.M. LinkRegeneration of the donor side after autogenous fibula transplantation in 53 patients: evaluation by dual x-ray absorptiometry Acta Orthop Scand, 74 (2003), pp. 332-336
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6. C.W. Steinlechner, N.C. MkandawireNon-vascularised fibular transfer in the management of defects of long bones after sequestrectomy in children J Bone Joint Surg Br, 87 (2005), pp. 1259-1263.

How to Cite this article: Shekhar S, Shetty V, Wagh Y. Challenges and Difficulties faced by Orthopedic Surgeons during the COVID-19 Pandemic: A Review of Modified Surgical Protocols. Journal of Clinical Orthopaedics July-Dec 2020;5(2):45-48.

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