A new and effective treatment plan for chronic osteomyelitis after intramedullary nail surgery for intertrochanteric fractures of the femur - carbon fiber rod bone cement combined with calcium sulfate loaded with antibiotics

Abstract Background: Infection after intramedullary nail fixation of intertrochanteric fractures is relatively rare at present. This article aims to explore and compare the therapeutic effects of combined treatment with antibiotic bone cement carbon fiber rods loaded with antibiotic calcium sulfate and the traditional Masquelet technique in the treatment of chronic osteomyelitis after intramedullary nail fixation of intertrochanteric fractures. Methods: A retrospective analysis was conducted on a total of 88 patients with chronic osteomyelitis after intramedullary nail internal fixation of intertrochanteric fractures in our hospital from September 2018 to September 2024. The patients were divided into two groups by random number expression method, with 44 people in each group. The control group was treated with the Masquelet technique. After debridement, the first stage was treated with antibiotic bone cement rods, and the second stage was bone grafting. The experimental group was treated with the antibiotic calcium sulfate in the second stage on the basis of the first stage of the control group. The inflammatory indicators, therapeutic effects and pain conditions of the patients at 6 weeks after the operation were recorded. Corresponding evaluations were conducted for the two groups respectively to comprehensively assess and compare the therapeutic effects of the two surgical methods. Results: The wound healing time and bone healing time of the patients in the experimental group were shorter than those in the control group, and the total effective rate was higher than that in the control group. There was no significant difference in the operation time between the two groups. The levels of postoperative inflammatory indicators in both groups were significantly reduced compared with those before treatment, and the levels in the experimental group were significantly lower than those in the control group. The pain scores of the two groups of patients showed a decreasing trend 2 weeks, 1 month after treatment and 3 months after follow-up, and the pain scores of the experimental group were all lower than those of the control group. Conclusion: The combined treatment of postoperative infection with antibiotic bone cement carbon fiber rods loaded with antibiotic calcium sulfate in the proximal femur can effectively reduce inflammatory responses and pain. While eliminating infection, it also has the effect of osteogenic formation. The postoperative recurrence rate is greatly reduced, and it has good clinical efficacy.