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Use of cemented spacer with a handmade stem to treat acute periprosthetic tibial fracture infection: a case report.

Font-Vizcarra L, Izquierdo O, García-Nuño L, González A, Diaz-Brito V, Castellanos J - Open Orthop J (2014)

Bottom Line: All the components were removed and a bone-cement spacer with a handmade stem with a metal core was implanted.After 24 months, the patient was able to sit without pain and to stand up with help using a knee brace.There were no radiological or clinical signs of infection.

View Article: PubMed Central - PubMed

Affiliation: Department of Orthopaedics and Trauma Surgery of Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregat, Barcelona, Spain.

ABSTRACT
We report an 85-year-old woman with dementia and dependent for normal life activities who was admitted due to a left periprosthetic tibial fracture. The tibial component was replaced by one with a long stem and she was discharged. Four weeks after the intervention the patient was re-admitted due to an acute prosthetic joint infection. All the components were removed and a bone-cement spacer with a handmade stem with a metal core was implanted. Radiological signs of fracture consolidation were observed after 3 months of follow-up. Due to the previous health status of the patient, it was decided to keep the spacer as a definitive treatment. After 24 months, the patient was able to sit without pain and to stand up with help using a knee brace. There were no radiological or clinical signs of infection.

No MeSH data available.


Related in: MedlinePlus

AP and lateral X-rays showing type IIB periprosthetictibial fracture.
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Figure 1: AP and lateral X-rays showing type IIB periprosthetictibial fracture.

Mentions: An 85-year-old woman with hypertension, dementia and dependent for normal life activities presented after an accidental fall with a left periprosthetic tibial fracture around total knee arthroplasty (Alpina®, Biomet-France) implanted 9 years ago (Fig. 1). The fracture was classified as type IIB according to the Felix classification [2] (adjacent to the stem and with an unstable tibial component). To treat this lesion, areplacement of the tibial component by one with a long stem was performed (Fig. 2). Although the patient was discharged two weeks later without clinical complications, she was readmitted 4 weeks after the intervention due to wound drainage. Acute prosthetic joint infection was suspected and a surgical debridement was performed. The intraoperative cultures were positive for extended-spectrum beta-lactamase (ESBL) producing Escherichia coli and ampicillin- and high


Use of cemented spacer with a handmade stem to treat acute periprosthetic tibial fracture infection: a case report.

Font-Vizcarra L, Izquierdo O, García-Nuño L, González A, Diaz-Brito V, Castellanos J - Open Orthop J (2014)

AP and lateral X-rays showing type IIB periprosthetictibial fracture.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3927377&req=5

Figure 1: AP and lateral X-rays showing type IIB periprosthetictibial fracture.
Mentions: An 85-year-old woman with hypertension, dementia and dependent for normal life activities presented after an accidental fall with a left periprosthetic tibial fracture around total knee arthroplasty (Alpina®, Biomet-France) implanted 9 years ago (Fig. 1). The fracture was classified as type IIB according to the Felix classification [2] (adjacent to the stem and with an unstable tibial component). To treat this lesion, areplacement of the tibial component by one with a long stem was performed (Fig. 2). Although the patient was discharged two weeks later without clinical complications, she was readmitted 4 weeks after the intervention due to wound drainage. Acute prosthetic joint infection was suspected and a surgical debridement was performed. The intraoperative cultures were positive for extended-spectrum beta-lactamase (ESBL) producing Escherichia coli and ampicillin- and high

Bottom Line: All the components were removed and a bone-cement spacer with a handmade stem with a metal core was implanted.After 24 months, the patient was able to sit without pain and to stand up with help using a knee brace.There were no radiological or clinical signs of infection.

View Article: PubMed Central - PubMed

Affiliation: Department of Orthopaedics and Trauma Surgery of Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregat, Barcelona, Spain.

ABSTRACT
We report an 85-year-old woman with dementia and dependent for normal life activities who was admitted due to a left periprosthetic tibial fracture. The tibial component was replaced by one with a long stem and she was discharged. Four weeks after the intervention the patient was re-admitted due to an acute prosthetic joint infection. All the components were removed and a bone-cement spacer with a handmade stem with a metal core was implanted. Radiological signs of fracture consolidation were observed after 3 months of follow-up. Due to the previous health status of the patient, it was decided to keep the spacer as a definitive treatment. After 24 months, the patient was able to sit without pain and to stand up with help using a knee brace. There were no radiological or clinical signs of infection.

No MeSH data available.


Related in: MedlinePlus