Clinical efficacy of bone transport and induced membrane technique with antibiotic-loaded cement in treatment of elderly patients with infectious nonunion after open fracture of tibia
Received:June 22, 2018  Revised:August 07, 2018
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DOI:10.11915/j.issn.1671-5403.2019.01.005
Key words:aged; fracture; infectious nonunion; bone transport technique
Author NameAffiliationE-mail
ZHAO Li-Bo Department of Orthopedics, Hainan Hospital of Chinese PLA General Hospital, Sanya 572000, China  
HU Wen-Shan Department of Orthopedics, Hainan Hospital of Chinese PLA General Hospital, Sanya 572000, China  
ZHANG Qun Department of Orthopedics, the First Medical Center of Chinese PLA General Hospital, Beijing 100853, China 2544876457@qq.com 
LIN Feng Department of Orthopedics, Hainan Hospital of Chinese PLA General Hospital, Sanya 572000, China lyf1011@aliyun.com 
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Abstract:
      Objective To compare the clinical efficacy of bone transport with antibiotic bone cement combined with membrane induction in the treatment of infectious nonunion after open tibial fracture in the elderly. Methods A retrospective study was performed on 72 elderly patients with infectious nonunion after open tibial fractures who admitted to our 2 Orthopedic Departments from May 2013 to May 2016. According to the treatment, they were assigned into study group (n=36, bone transport) and control group (n=36, antibiotic bone cement combined with membrane induction). All the patients were followed up for 12 months. The contralateral alignment, bone healing index, American Knee Society (AKS) score for knee function, Baird-Jackson score of ankle function and clinical outcomes were compared between the 2 groups. The data were analyzed by SPSS statistics 19.0 software. Chi-square test or Student′s t test was used for the comparison between the 2 groups. Results There was no significant differences in age, sex and fracture location between the 2 groups (P>0.05). The study group had significantly shorter operation time [(135±17) vs (146±12)min], higher AKS score [(165.7±15.2) vs (123.7±18.1)] and Baird-Jackson score [(88.6±3.6) vs (77.6±5.4)] and lower bone healing index [(42.0±2.0) vs (43.3±3.0)d/cm], better clinical efficacy [61.1% (22/36) vs 47.2% (17/36)], and lower incidence of infection [5.6% (2/36) vs 25.0% (9/36)] when compared with the control group (all P<0.05). Conclusion Bone transport technique can promote the functional recovery in the elderly patients with infectious nonunion after open tibial fracture, and it is worthy of clinical promotion.
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