Use of the Reamer Irrigator Aspirator for the Treatment of a 20-Year Recurrent Osteomyelitis of a Healed Femur Fracture

Abstract

In the following case, a 20-year-old male was involved in a motorcycle accident where he sustained an open midshaft femur fracture treated with open reduction and internal fixation. Several weeks later, the wound became infected and the plate was removed. Over the following 20 years numerous incision and debridements were performed, with multiple courses of antibiotics for persisting infection. One year following reaming with the reamer-irrigator-aspirator (RIA), the patient is symptom free. It is our belief that organisms were sequestered in the fibrous and bony tissue at the healed fracture site, and, by opening the canal and allowing it to revascularize, the infection was cleared.

Reamer-irrigator-aspirator indications and clinical results: a systematic review

“…The RIA reamer has been reported as an effective adjunct when treating postoperative long-bone osteomyelitis by providing IM debridement and lavage [4,18]. Zalvras et al reported an 11 patient case series (eight tibia, three femur)…”

Comparison of Free Fibular Flaps With Reamer-Irrigator-Aspirator Bone Grafts for the Reconstruction of Critical-Sized Mandibular Defects

“…It reduces the risk of fat emboli 6 compared with other reamers and has been shown to result in less postoperative pain than iliac bone grafting. 32 On the basis of volumetric and morphologic studies, RIA is equally effective as free fibular flaps to reconstruct mandibular defects in this porcine model. 7,10,11,28 However, no studies comparing it with vascularized bone or its used in radiated tissue have been performed.…”

First mid-term results after cancellous allograft vitalized with autologous bone marrow for infected femoral non-union

“…The microbiologic specimens were all negative at the time of VABG, so that we stated an infection eradication of 100 %. We observed These goals can also be achieved by using the Reamer-Irrigator-Aspirator (RIA) Tool [29]. Stabilization is possible by means of external fixation or secondary internal fixation using plates or renailing of the femur.…”