Treatment of infected tibial nonunion with tobramycin-impregnated calcium sulfate: report of two cases
Tsai, Y-Hung.; Tsung-Jen, H.; Shih, H-Nung.; Hsu, R.Wen-Wei.
Chang Gung Medical Journal 27(7): 542-547
2004
ISSN/ISBN: 2072-0939 PMID: 15508877 Document Number: 575004
The treatment of infected tibial nonunion usually includes a staged reconstruction protocol. We present 2 patients with tibial nonunion and plate loosening with oxacillin-resistant Staphylococcus aureus infection. The patients were treated using the removal of the plate, radical debridement, and implantation of gentamycin-impregnated cement beads during the first stage. During the second stage, plate fixation was performed and tobramycin-impregnated calcium sulfate (Osteoset T) was used as a bone graft substitute. Neither an autogenous bone graft nor an allograft was used. At 3 years of follow-up, each tibia showed good union, and there was no recurrence of infection. We consider tobramycin-impregnated calcium sulfate to be an alternative method of bone grafting to treat infected tibial nonunion.