ArticleEuropean journal of orthopaedic surgery & traumatology : orthopedie traumatologie2023
Intramedullary application of local antibiotic bullets for the treatment of long bone fracture related infection.
Article in European journal of orthopaedic surgery & traumatology : orthopedie traumatologie, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers.
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Who cites it
11 citing papers in PubMed, 9 citations in OpenAlex.
- Antibiotic-loaded synthetic calcium sulfate (Stimulan) in the surgical management of fracture-related complications in a low-middle income country.European journal of orthopaedic surgery & traumatology : orthopedie traumatologie · 2026Article
- Reported practice patterns in the use of local antibiotics for fracture-related infection among SICOT respondents: an international survey.BMC musculoskeletal disorders · 2026Article
- Outcomes and safety of antibiotic-loaded calcium sulfate beads in orthopaedics: A systematic review and meta-analysis.Journal of orthopaedics · 2026Review
- Article
- Orthopaedic infections: novel treatment strategies and evolving concepts.OTA international : the open access journal of orthopaedic trauma · 2025Article
- Safety and efficacy of antibiotic-impregnated absorbable calcium sulfate beads (Stimulan) in cranioplasty.Journal of surgical case reports · 2024Article
- Microbiological Profile of Fracture Related Infection at a UK Major Trauma Centre.Antibiotics (Basel, Switzerland) · 2023Article
- Current Concepts of Fracture-Related Infection.International journal of clinical practice · 2023Review
- The efficacy of antibiotic-impregnated calcium sulfate (AICS) in the treatment of infected non-union and fracture-related infection: a systematic review.Journal of bone and joint infection · 2023Article
- Does the Use of Local Antibiotics Affect Clinical Outcome of Patients with Fracture-Related Infection?Antibiotics (Basel, Switzerland) · 2022Article
- Review
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Authors and funding
5 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeThe optimal means of local antibiotic delivery for fracture related infection is unknown. Until now, intramedullary application of calcium sulphate based local antibiotics has been challenging. We report on the use of a newly available mode of preparation and delivery: the Stimulan Bullet Mat and Introducer (Biocomposites Ltd, Staffordshire, England).
methodsA retrospective analysis of prospectively collected data for infection cases at two separate tertiary referral institutions was performed. We included cases of long bone FRI with a retained intramedullary nail, treated with a single stage protocol of metalwork removal, debridement, local antibiotic application using the novel mould and applicator, with additional bony stabilisation and soft tissue reconstruction where required.
resultsAll 13 patients achieved infection remission rate with an average follow-up of 19.7 months (range 12-28). All 6 patients with infection around an unhealed fracture achieved union at an average 8 months (range 4-12) from debridement. No patients developed aseptic wound leak.
conclusionsAntibiotic impregnated calcium sulphate can be used safely as part of a single stage treatment protocol for the treatment of long bone fracture related infection following intramedullary nailing. We have demonstrated high rates of infection remission and union, using a newly available intramedullary applicator.
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