Methicillin-resistant Staphylococcus aureus infected pseudo-arthrosis of the distal tibia treated with debridement, mesh cage, autologous grafting and locking plate fixation
Infected non-union of long bones is a challenge to manage. It has a high morbidity and mortality. Treatment is very demanding and has a significant complication rate. Methicillin-resistant infected non-union has a higher morbidity and mortality compared to Methicillin-sensitive Staphylococcus aureus infection. Approximately half of all Staphylococci isolated in infected orthopaedic operations are caused by Methicillin-resistant S. aureus. We present a 42-year-old patient who had Methicillin-resistant S. aureus infected pseudo-arthrosis of the tibia that was treated with debridement, mesh cage, autologous bone-grafting, and plating of the tibia. The outcome was satisfactory despite residual limb deformity and discrepancy.
Cobos JA, Lindsey RW, Gugala Z (2000) The cylindrical titanium cage for treatment of a long bone segmental defect: description of a new technique and report of two cases. J Orthop Trauma 14(1):54-59
Harwood PJ, Talbot C, Dimoutsos M, Sunderland G, Shaw D, Wilcox MH, Giannoudis PV (2006) Early experience with linezolid for infections in orthopaedics. Injury 37:818-826
Shilov BL (2006) The first case of primary metacarpal V restoration with titanium mesh and cancellous bone graft. J Plastic Reconstr Aesthet Surg 59:1391-1393
Attias N, Lindsey RW (2006) Management of large segmental tibial defect using a cylindrical mesh cage. Clin Orthop Relat Res 450:259-266
Attias N, Lehman RE, Bodell LS, Lindsey RW (2005) Surgical management of a long segmental defect of the humerus using a cylindrical titanium mesh cage and plates. J Orthop Trauma 19(3):211-216
Panchbhavi VK, Trevino SG (2003) Use of titanium cages with cancellous bone graft in hindfoot fusion: literature and case report with complications. Foot Ankle Surg 9:51-55
Cosgrove SE, Qi Y, Kaye KS, Harbarth S, Karchmer AW, Carmeli Y (2005) The impact of Methicillin-resistant in Staphylococcus aureus bacteremia on patient outcome: mortality, length of stay, and hospital charges. Infect Control Hosp Epidemiol 26(2):166-174
Yamaoka T (2007) The bactericidal effects of anti-MRSA agents with rifampicin and sulfamethoxazole-trimethoprim against intracellular phagocytized MRSA. J Infect Chemother 13:141-146
Kinik H, Karaduman M (2008) Cierny-Mader Type III Chronic osteomyelitis: the results of patients treated with debridement, irrigation, vancomycin beads and systemic antibiotics. Int Orthop 32:551-558. doi: 10.1007/s00264-007-0342-9
Ozaki T, Yoshitaka T, Kunisada T, Dan'ura T, Naito N, Inoue H (1998) Vancomycin-Impregnated polymethylmethacrylate beads for methicilin-resitant Staphylococcus aureus (MRSA) infection: report of two cases. J Orthop Sci 3:163-168
