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VOLUME 17 , ISSUE 2 ( May-August, 2022 ) > List of Articles


Intramedullary Canal Injection of Vancomycin- and Tobramycin-loaded Calcium Sulfate: A Novel Technique for the Treatment of Chronic Intramedullary Osteomyelitis

Ahmed H Elhessy, Jessica C Rivera, Henry T Shu, Taj-Jamal Andrews, John E Herzenberg, Janet D Conway

Keywords : Antibiotic-loaded calcium sulfate, Bone infection, Chronic osteomyelitis, Local antibiotic delivery, Long bone infection, Retrospective review

Citation Information : Elhessy AH, Rivera JC, Shu HT, Andrews T, Herzenberg JE, Conway JD. Intramedullary Canal Injection of Vancomycin- and Tobramycin-loaded Calcium Sulfate: A Novel Technique for the Treatment of Chronic Intramedullary Osteomyelitis. 2022; 17 (2):123-130.

DOI: 10.5005/jp-journals-10080-1554

License: CC BY-NC-SA 4.0

Published Online: 28-07-2022

Copyright Statement:  Copyright © 2022; The Author(s).


Aim: In this study, we present a detailed surgical technique for treating chronic osteomyelitis (COM) of the intramedullary canal with injectable tobramycin and vancomycin-loaded calcium sulfate (CS). Background: Chronic osteomyelitis of the long bones has been treated using antibiotic-impregnated polymethyl methacrylate (PMMA), which typically requires a second procedure for removal. Technique: Removal of the infected intramedullary nail (if any), copious irrigation, canal reaming, and intramedullary canal injection of vancomycin- and tobramycin-loaded calcium sulfate as a single-stage procedure for the treatment of COM of long bones. Conclusion: Intramedullary injection of vancomycin- and tobramycin-loaded CS can be used as a single-stage procedure for the treatment of long bone intramedullary COM. Further studies are necessary to compare the long-term outcomes of antibiotic-coated CS vs other antibiotic carriers for infection eradication. Clinical significance: The authors have endeavored to explain the best surgical technique to eradicate long bones COM with injectable tobramycin and vancomycin-loaded CS.

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