Post-Traumatic Tsteomyelitis of the Cierny-Mader IV Femur Treated with an External Fixation Stent Combined with Loaded Calcium Sulfate - Abstract
Background: Good results have been achieved by using external fixation stents combined with drug-loaded calcium sulfate in the treatment of Cierny-Mader type IV posttraumatic osteomyelitis of the femur, but fewer clinical studies have been reported.
Methods” The purpose of this study is to investigate the application of this method for the treatment of Cierny-Mader type IV post-traumatic osteomyelitis of the femur to control
infection, repair bone defects, use an use an external fixation bracket to provide stable bone support and protection, reduce interfracture mobility, promote repair and regeneration
of bone tissue, improve the rate of healing of osteomyelitis, and explore the clinical efficacy and advantages of this method.
Results: Twelve patients were treated with loaded calcium sulfate, and the antibiotics chosen were vancomycin in 11 cases and vancomycin combined with gentamicin in one
case, with a follow-up period of 31-49 months and a mean follow-up period of 39.17 months. The results of serological examination showed that WBC, CRP, and ESR were lower
at 1 month postoperatively than preoperatively, and the difference was statistically significant (P<0.05). PCT and IL-6 were lower at 1 month postoperatively than preoperatively,
but the difference was not statistically significant (P > 0.05). Twelve cases of osteomyelitis were cured without recurrence, and according to the Paley scoring system, 5 cases were
excellent, 5 cases were good, and 2 cases were poor, with an excellent rate of 83.33%. According to the LEFS grading criteria, 6 cases were excellent, 4 cases were good, and 2
cases were poor, with an excellent rate of 83.33%. According to the Likert satisfaction scale, 9 cases were very satisfied, 2 cases were satisfied, and 1 case was fair, with an excellent
satisfaction rate of 91.67%. After treatment with the external fixation stent combined with drug-carrying calcium sulphate, all patients achieved more satisfactory clinical efficacy.
Conclusion: For the treatment of Cierny-Mader type IV post-traumatic osteomyelitis of the femur, external fixation stents in combination with drug-loaded calcium sulphate are
a better option because they are dependable, have fewer surgical complications, and have a lower recurrence rate.