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Treatment of Infected Tibial Nonunion with Tobramycin- Impregnated Calcium Sulfate: Report of Two Cases.

Author(s): Yao-Hung Tsai | Tsung-Jen, Huang | Hsin-Nung Shih | Robert Wen-Wei Hsu

Journal: Chang Gung Medical Journal
ISSN 2072-0939

Volume: 27;
Issue: 07;
Start page: 542;
Date: 2004;
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Keywords: osteomyelitis | osteoset | tibia.

The treatment of infected tibial nonunion usually includes a staged reconstruction protocol.We present 2 patients with tibial nonunion and plate loosening with oxacillin-resistantStaphylococcus aureus infection. The patients were treated using the removal of the plate,radical debridement, and implantation of gentamycin-impregnated cement beads during thefirst stage. During the second stage, plate fixation was performed and tobramycin-impregnatedcalcium sulfate (Osteoset T®) was used as a bone graft substitute. Neither an autogenousbone graft nor an allograft was used. At 3 years of follow-up, each tibia showed goodunion, and there was no recurrence of infection. We consider tobramycin-impregnated calciumsulfate to be an alternative method of bone grafting to treat infected tibial nonunion.
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