Paley and Herzenberg describe a technique for treating intramedullary infections using custom-made antibiotic cement rods built intraoperatively from chest tube molds with an embedded guidewire, comparing this approach to standard antibiotic bead chains in a nine-case retrospective review across femur, tibia, and humerus infections.
When you remove an infected intramedullary nail from a bone that is not yet healed, a cement rod made from a chest tube mold with tobramycin-vancomycin PMMA fills dead space, delivers local antibiotics, and provides enough stability to bridge to definitive exchange nailing — address active nonunion promptly, as cyclic loading will fracture the rod if left beyond one year.
Paley and Herzenberg describe a technique for treating intramedullary infections using custom-made antibiotic cement rods built intraoperatively from chest tube molds with an embedded guidewire, comparing this approach to standard antibiotic bead chains in a nine-case retrospective review across femur, tibia, and humerus infections.
When you remove an infected intramedullary nail from a bone that is not yet healed, a cement rod made from a chest tube mold with tobramycin-vancomycin PMMA fills dead space, delivers local antibiotics, and provides enough stability to bridge to definitive exchange nailing — address active nonunion promptly, as cyclic loading will fracture the rod if left beyond one year.