Intramedullary infection in long bones represents
a complex clinical challenge, with an increasing incidence due to the
increasing use of intramedullary fixation. We report a prospective
case series using an intramedullary reaming device, the Reamer–Irrigator–Aspirator
(RIA) system, in association with antibiotic cement rods for the
treatment of lower limb long bone infections. A total of 24 such
patients, 16 men and eight women, with a mean age of 44.5 years
(17 to 75), 14 with femoral and 10 with tibial infection, were treated
in a staged manner over a period of 2.5 years in a single referral
centre. Of these, 21 patients had had previous surgery, usually
for fixation of a fracture (seven had sustained an open fracture
originally and one had undergone fasciotomies). According to the
Cierny–Mader classification system, 18 patients were classified
as type 1A, four as 3A (discharging sinus tract), one as type 4A
and one as type 1B. Cite this article:
The December 2012 Trauma Roundup360 looks at: whether tranexamic acid stops bleeding in trauma across the board; antibiotic beads and VAC; whether anaesthetic determines the outcome in surgery for distal radial fractures; high complications in surgery on bisphosphonate-hardened bone; better outcomes but more dislocations in femoral neck fractures; the mythical hip fracture; plate augmentation in nonunion surgery; and SIGN intramedullary nailing and infections.