Janet D. Conway, MD, Lee M. Hlad, DPM, and Samantha E. Bark, DPM
Authors’ Disclosure Statement: Dr. Conway wishes to report that she is a paid consultant for Biomet and Medtronic and received research support from Medtronic for an unrelated study. The other authors report no actual or potential conflict of interest in relation to this article.
Broad-spectrum antibiotics are used to coat the plate in order to cover as many microbial organisms as possible without knowing the final offending organism. In our experience, this current technique provides antibiotic delivery with bony stability, therefore eliminating the need for multiple sequential surgical procedures. This difficult patient problem does not occur with enough frequency to warrant a large randomized clinical trial. However, this technique has been effective in these cases and may be useful to orthopedic surgeons in the future.
Conclusion
Based on our experience, early aggressive débridement, coupled with broad-spectrum antibiotic cement–coated plate insertion, provides fracture stability and helps eradicate the infection with 1 surgical procedure.