A Case of Osteomyelitis after Calcaneal Fracture Treated by Antibiotic-Containing Calcium Phosphate Cements

Kim, Yoohak; Inori, Fumiaki; Yamanaka, K; Murakami, Shouichi; Narita, Eri; Yamamura, Kazumasa; Yasuda, Hiroyuki; Fukuda, Makoto; Konishi, Sadahiko; Minoda, Yukihide

doi:10.1155/2018/9321830

Cited by 6 publications

(5 citation statements)

References 30 publications

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“…PMMA can be used as bone defect filler and for local antibiotic delivery system because of its higher mechanical durability. However, as it is non-biodegradable, it requires second surgery for its removal [ 5 ]. Biodegradable substances like calcium sulphate (STIMULAN®, Biocomposites) can be used for the same purpose but are less mechanically robust.…”

Section: Discussionmentioning

confidence: 99%

Calcaneal Osteomyelitis Treated with Antibiotic Mixed Calcium Sulphate Pellets. A Case Report

Agrawal¹,

Ojha²,

Garg³

et al. 2021

JOCR

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Background: Calcaneal osteomyelitis is a complicated entity and much more challenging to treat. We present a case of calcaneal osteomyelitis treated with debridement, curettage and filling bone defect with antibiotic mixed calcium sulphate pellets. Case Report: A female patient presented with pain, swelling and purulent discharge from the left heel. Culture studies and magnetic resonance imaging findings were suggestive of osteomyelitis of the calcaneum. The patient was planned for definitive treatment, and remission was achieved with systemic antibiotics, debridement, curettage, and filling dead space with antibiotic mixed calcium sulphate pellets. Conclusion: Calcaneal osteomyelitis is very resistant to treatment and results in poor functional outcome. Management of calcaneal osteomyelitis with single-stage strategy using antibiotic mixed calcium sulphate effectively eradicates the disease to attain overall good functional outcome for the patient. Keywords: Calcaneum, osteomyelitis, debridement, calcium sulphate.

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Section: Discussionmentioning

confidence: 99%

Calcaneal Osteomyelitis Treated with Antibiotic Mixed Calcium Sulphate Pellets. A Case Report

Agrawal¹,

Ojha²,

Garg³

et al. 2021

JOCR

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“…29,30 The cancelloplasty serves as a medium between radical resection of infected bone and parenteral antibiotics alone. The instillation of a "central reservoir" of impregnated calcium phosphate cement serves to provide a high concentration of local antimicrobials, with the ability to elute over 4 weeks, 16 providing a more effective means of treating infected bone with structural augment. The benefit of using calcium phosphate as a carrier is the neutral setting temperature, pore size, structural similarity, and slow rate of elution.…”

Section: Discussionmentioning

confidence: 99%

“…Freely flowable paste that hardens can be used to custom-fill defects with an advantage over finite solid structures such as beads. 16 Calcium phosphate composite substitutes demonstrates less subsidence, a higher load to failure, as well as higher rigidity in regards to treatment of tibial plateau fractures in comparison to autograft. 17…”

Section: Properties Of Calcium Phosphate Bone Substitutementioning

confidence: 98%

“…With regard to previous documented use of calcium phosphate in the calcaneus, Kim et al 16 published a case report in which the bone substitute was used to treat osteomyelitis following open reduction internal fixation of a calcaneal fracture. However, in this case wide surgical debridement of the infected calcaneal body was performed prior to instillation of calcium phosphate.…”

Section: Previous Datamentioning

confidence: 99%

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Cancelloplasty for Treatment of Osteomyelitis of the Calcaneus: A Novel Technique and Case Report

Huchital¹,

Saleh

Patel³

et al. 2020

Foot & Ankle Specialist

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Calcaneal osteomyelitis has the potential to cause limb- and life-threatening complications. The anatomic and biomechanical attributes of the heel make limb salvage in the setting of bone infection complex. Current treatment options include surgical resection of part or all of the calcaneus, lower extremity amputation, or prolonged intravenous antibiotic usage. Each modality has its own inherent disadvantages. We present a novel surgical technique using antibiotic-impregnated calcium phosphate as an alternative treatment option coupled with ultrasonic bone dissection as a method for enhancing delivery of antibiotics, while mitigating tissue damage and maintaining osseous integrity. The details of the surgical technique are discussed along with a single case example.

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“…Kim et al 24 used antibiotic-containing calcium phosphate cements for filling the cavity in the calcaneus after its intralesional resection with good results. Other authors share this view.…”

Section: Introductionmentioning

confidence: 99%

The Concept of Treatment for Surgical Infection in the Hindfoot

Alizade,

Aliyev,

Alizada

2024

Foot & Ankle Orthopaedics

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Background: Chronic osteomyelitis of the calcaneus (OC) and open infected calcaneal fractures, especially when complicated by infected soft tissue defects, present significant surgical challenges. Accepted recommendations for the surgical treatment of this pathology are yet to be established. Methods: Drawing from our experience and the consensus among experts, we have developed a concept for selecting optimal, well-known surgical approaches based on the specific pathologic presentation. This concept distinguishes 4 main forms of hindfoot infection: infected wounds, open infected fractures, OC, and their mixed forms. Patients with conditions that could confound the treatment outcomes, such as diabetes mellitus and neurotrophic diseases, were excluded from this analysis. We present a retrospective analysis of the treatment outcomes for 44 patients (4 women and 40 men) treated between 2009 and 2022 using some refined surgical techniques. Treatment success was evaluated based on the absence of disease recurrence within a 2-year follow-up, the avoidance of below-knee amputations, and the restoration of weightbearing function. Results: The treatment results were considered through the prism of our proposed concept and according to the Cierny-Mader classification. There were 4 instances of disease recurrence, necessitating 6 additional surgeries, 2 of which (4.5% of the patient cohort) resulted in amputations. In the remaining cases, we were able to restore weightbearing function and eliminate the infection through reconstructive surgeries, employing skin grafts when necessary. Conclusion: Surgical infections of the hindfoot area remain a significant challenge. The strategic concept we propose for surgical decision making, tailored to the specific pathology, represents a potential advancement in addressing this challenge. This framework could provide valuable guidance for orthopaedic surgeons in their clinical decision-making process. Level of Evidence: Level IV, case series.

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A Case of Osteomyelitis after Calcaneal Fracture Treated by Antibiotic-Containing Calcium Phosphate Cements

Cited by 6 publications

References 30 publications

Calcaneal Osteomyelitis Treated with Antibiotic Mixed Calcium Sulphate Pellets. A Case Report

Calcaneal Osteomyelitis Treated with Antibiotic Mixed Calcium Sulphate Pellets. A Case Report

Cancelloplasty for Treatment of Osteomyelitis of the Calcaneus: A Novel Technique and Case Report

The Concept of Treatment for Surgical Infection in the Hindfoot

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