Clinical effectiveness of vancomycin loaded bone cement versus traditional antibiotics infusion in treatment of intramedullary infection after internal fixation

Objective To compare the clinical effectiveness of vancomycin loaded bone cement versus continuous vancomycin infusion in the treatment of intramedullary infection after internal fixation. Methods A total of 36 patients with intramedullary infection after internal fixation admitted to our hospital from January 2013 to October 2015 were assigned to 2 groups.Group A including 20 patients with 14 males and 6 females at an average age of (40.5±2.0) years was treated by vancomycin loaded bone cement; Group B including 16 patients within 12 males and 4 females at an average age of (38.8±1.2) years was treated by continuous vancomycin irrigation.The clinical cure rate, recurrence rate, infection indexes and pain improvement of the two groups were analyzed and compared. Results All patients were followed up for 8-12 months with an average of 9.4 months.Of them, 32 cases were cured, 4 cases recurred.All the recurred cases were in group B.The cure rates were 100% in group A versus 75% in group B with signi ficant difference (P＜ 0.05).Time of ESR, CRP, WBC, NUET return to normal level were 3 d, 3 d, 4 d and 4 d in group A, respectively, and 6 d, 7 d, 7 d, 6 d in group B, respectively, with statistically signi ficant differences between two groups (P＜ 0.01, respectively).There was no significant difference in VAS score between two groups before operation, and the differences were statistically significant at 24 h, 72 h, 1 week and 3 weeks after surgery (P＜ 0.01, respectively). Conclusion Placement of vancomycin loaded bone cement is a feasible and effective treatment for intramedullary infection after internal fixation.