Effectiveness of antibiotic-impregnated bone cement in treating postoperative infections after femoral shaft fracture treatment with intramedullary nailing

Postoperative infections are a significant challenge in orthopedic surgeries, particularly after procedures involving femoral shaft fractures treated with intramedullary nailing. Antibiotic-impregnated bone cement (AIBC) offers a promising solution by providing targeted antimicrobial delivery to the surgical site, potentially enhancing infection control and bone healing. A retrospective analysis was conducted from January 2020 to January 2023, involving 40 patients who developed postoperative infections after femoral shaft fracture treatment with intramedullary nailing. All patients underwent surgical debridement, removal of the original intramedullary nail, reaming of the medullary canal, and implantation of antibiotic-impregnated bone cement rods tailored with vancomycin. Patients were followed for 12 months to assess infection recurrence, bone healing, changes in inflammatory markers (white blood cell count, erythrocyte sedimentation rate, C-reactive protein, and procalcitonin), and functional outcomes including lower limb motor function and daily living activities. All 40 patients showed no signs of infection recurrence, achieving a 100% success rate in managing postoperative infections. Radiological assessments confirmed complete osseous union in all cases. Inflammatory markers significantly decreased post-surgery, indicating effective inflammation control. Significant improvements were also noted in motor functions and daily living activities, as measured by the Fugl-Meyer Assessment and the Activities of Daily Living scales. The use of antibiotic-impregnated bone cement in the treatment of postoperative infections following femoral shaft fracture treatment with intramedullary nailing is highly effective. AIBC not only prevents infection recurrence but also supports robust bone healing and functional recovery. This treatment approach holds promise for broader application in orthopedic surgery.