Journal of clinical orthopaedics and trauma
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J Clin Orthop Trauma · Mar 2013
An alternative management option for infected non-union of long bone fractures.
Management of infected non-union following fracture of a long bone is a challenge to the orthopaedic surgeon. Several methods of treating these cases have been described.(1-7) Although reports of single stage or multiple stage procedures exist in the literature, general consensus appears to favour a two-stage approach with initial debridement followed by the use of local antibiotic cement in the first stage.(2,5,8) This antibiotic-impregnated cement has been reported in previous papers as placed around an intramedullary nail or via antibiotic cement beads,(4-6,9) Cement beads offer no mechanical stability to the fracture site. ⋯ We describe the use of an antibiotic cement nail fashioned by hand intra-operatively around a length of nylon tape. This eliminates the need for further metalwork during the infected stage, thereby reducing the chance of persistent non-union as well as providing some stability across the fracture site.