Therapeutic effect of modified iliac bone graft combined with antibiotic bone cement on lower limb bone infection complicated with large segment bone defect: An Observational Study

TL;DR

This study shows that combining modified iliac bone graft with antibiotic bone cement improves treatment outcomes for lower limb bone infections with large bone defects.

Contribution

The study introduces a modified surgical technique combining iliac bone graft and antibiotic bone cement for treating complex bone infections.

Findings

Patients treated with antibiotic cement had better healing rates and lower infection rates compared to the control group.

Infection range, BMI, and postoperative C-reactive protein were identified as independent risk factors for surgical efficacy.

All patients achieved fracture union within 3 months and returned to normal function within 6 months with no infection recurrence at 12 months.

Abstract

Lower limb bone infection, particularly when combined with large segmental bone defects, poses significant challenges in treatment, often resulting in recurrence and complications. Traditional methods like surgical debridement and bone transplantation exhibit limited efficacy and high postoperative complications.

The objective of this study was to investigate the efficacy of modified iliac bone graft combined with antibiotic bone cement in the treatment of lower limb bone infection complicated with large segment bone defect.

The clinical data of 50 patients with lower limb bone infection complicated with large segment bone defect who received modified iliac bone graft combined with antibiotic bone cement technique in our hospital from January 2018 to December 2022 were retrospectively analyzed. All patients were treated with modified iliac bone graft combined with antibiotic bone cement technique and received postoperative antibiotic therapy. The patients were followed up after the operation, and the therapeutic effect and complications were recorded.

The healing rate and healing time of the group with antibiotic cement were better than those of the control group without antibiotic cement in infection scope, infection event, deep infection, superficial infection and overall infection (P<0.05). Multiple Logistic regression analysis showed that infection range, BMI and postoperative C-reactive protein were independent risk factors for surgical efficacy (P<0.05), while the effects of weight, height, preoperative C-reactive protein, operative time and combined antibiotic therapy were not statistically significant (P>0.05). All patients completed fracture union within 3 months after surgery. All patients returned to normal lower limb function 6 months after surgery. At 12 months, follow-up showed no recurrence of infection or pain at the fracture site in all patients.

Modified iliac bone graft combined with antibiotic bone cement is an effective method for the treatment of lower limb bone infection complicated with large segment bone defect, which has significant therapeutic effect and low complication rate. Large-scale experiments are needed to further evaluate whether this method is recommended.

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