Table 3 Treatment result of infected nonunion
From: Early definitive internal fixation for infected nonunion of the lower limb
Patient # | Antibiotics | Previous implant | DS implant | Interval to DS (weeks) | Additional operation Why? How? | Bone defect size (cm) | Bone graft or transport | Radiological result | Functional result | Union time (weeks) | F/U (months) |
|---|---|---|---|---|---|---|---|---|---|---|---|
1 | Vancomycin | IM nail | IM nail | 2 | None | 2.5 | G | Excellent | Excellent | 16 | 12 |
2 | Cephalosporin | Plate | Plate | 2 | None | 5.2 | T | Excellent | Excellent | 24 | 53 |
3 | Tazocin | Plate | Plate | 3 | Recurrence of infection Implant removal Secondary debridement Changing of cement beads Ilizarov application (3 wks later) | 4.8 | T | Fair | Fair | 52 | 27 |
4 | Cefazolin | IM nail | IM nail | 4 | Intra op PMN > 20 HPF Secondary debridement Changing of cement beads IM nail (2 wks later) | 7.2 | G | Good | Good | 20 | 12 |
5 | Ceftazidime | Monofixator | Plate | 4 | Soft tissue defect Gastrocnemius Rotation flap Plate (2 wks later) | 2.5 | G | Good | Fair | 20 | 27 |
6 | Teicoplanin | IM nail | IM nail | 3 | None | 5.8 | G | Excellent | Excellent | 18 | 33 |
7 | Imipenem | Monofixator | I + P | 4 | Soft tissue defect Gastrocnemius Rotation flap IM nail (2 wks later) | 5.2 | T | Excellent | Good | 24 | 24 |
8 | Vancomycin | Monofixator | I + P | 2 | None | 5.9 | T | Good | Good | 16 | 12 |
9 | Cefepime + ciprofloxacin | Ilizarov | IM nail | 2 | None | 3.1 | G | Excellent | Excellent | 16 | 12 |
10 | Cephalosporin | Ilizarov | IM nail | 2 | None | 4.6 | G | Excellent | Excellent | 22 | 14 |
11 | Meropenem | Rt: Ilizarov Lt: Monofixator | I + P | 2 | None | 4.5 | T | Excellent | Good | 16 | 28 |
12 | Teicoplanin | Ilizarov | I + P | 2 | None | 3.2 | T | Good | Good | 35 | 15 |
13 | Cravit | Plate | Plate | 2 | None | 5.6 | T | Excellent | Excellent | 20 | 30 |
14 | Vancomycin | Plate | IM nail | 3 | None | 2.3 | G | Good | Good | 20 | 12 |
15 | Cefazedone | Plate | IM nail | 3 | Recurrence of infection Implant removal Secondary debridement Changing of cement beads IM nail (2 wks later) | 3.2 | G | Fair | Fair | 20 | 17 |
16 | Vancomycin | Plate | IM nail | 2 | None | 4.1 | G | Good | Good | 24 | 37 |
17 | Cravit + Rifampin | IM nail | IM nail | 2 | None | 1.8 | G | Excellent | Excellent | 20 | 12 |
18 | Unasyn | Plate | IM nail | 4 | Intra op PMN > 20 HPF Secondary debridement Changing of cement beads IM nail (2 wks later) | 4.1 | G | Fair | Fair | 20 | 24 |
19 | Cefaclor | Plate | IM nail | 2 | None | 2.2 | G | Excellent | Good | 24 | 24 |
20 | Gentamycin | Plate | I + P | 4 | Soft tissue defect Gastrocnemius Rotation flap I + P (2 wks later) | 10.2 | T | Excellent | Excellent | 20 | 30 |
21 | Cycin + Unasyn | Monofixator | IM nail | 2 | None | 6.1 | G | Good | Good | 18 | 16 |
22 | Ciprofloxacin | Plate | I + P | 4 | Soft tissue defect Rotation flap surgery IM nail (2 wks later) | 10.3 | T | Excellent | Excellent | 20 | 12 |
23 | Cefotaxime | Plate | Plate | 2 | None | 2.1 | G | Excellent | Excellent | 12 | 12 |
24 | Cefotaxime | Ilizarov | IM nail | 4 | Soft tissue defect Distally based hemisoleus flap I + P (2 wks later) | 2.9 | G | Excellent | Excellent | 12 | 12 |
25 | Cefotaxime | Ilizarov | I + P | 2 | None | 5.2 | T | Excellent | Excellent | 20 | 12 |
26 | Ciprofloxacin | Ilizarov | I + P | 2 | None | 7.8 | T | Excellent | Excellent | 12 | 12 |
27 | Ertapenem | Ilizarov | IM nail | 3 | None | 1.7 | G | Excellent | Excellent | 12 | 48 |
28 | Teicoplanin | Ilizarov | Plate | 2 | None | 3.5 | T | Excellent | Excellent | 20 | 24 |
29 | Ciprofloxacin | Ilizarov | Plate | 2 | None | 5.4 | T | Good | Good | 20 | 24 |
30 | Cefotaxime | Ilizarov | I + P | 4 | Soft tissue defect ALT flap surgery IM nail (2 wks later) | 4.8 | T | Good | Good | 24 | 24 |
31 | Teicoplanin | Plate | Plate | 4 | CRP = 40 mg/L (0 ~ 5 mg/L) Secondary debridement Changing of cement beads Plate (2 wks later) | 1.7 | G | Excellent | Excellent | 24 | 12 |
32 | Cefotaxime | Plate | IM nail | 3 | None | 1.6 | G | Excellent | Excellent | 24 | 12 |
33 | Cefotaxime | Plate | Plate | 4 | CRP = 50 mg/L Secondary debridement Changing of cement beads Plate (2 wks later) | 1.5 | G | Good | Excellent | 12 | 24 |
34 | Cefaclor | Plate | Plate | 2 | None | 1.4 | G | Excellent | Excellent | 20 | 48 |