Adjuvant Local Antibiotic Hydroxyapatite Bio-Composite in the management of open Gustilo Anderson IIIB fractures. Prospective Review of 80 Patients from the Manchester Ortho-Plastic Unit

Ahmed Aljawadi; Amirul Islam; Noman Jahangir; Noman Niazi; Zak Ferguson; Benjamin Sephton; Mohammed Elmajee; Adam Reid; Jason Wong; Anand Pillai

doi:10.1016/j.jor.2020.01.012

Adjuvant Local Antibiotic Hydroxyapatite Bio-Composite in the management of open Gustilo Anderson IIIB fractures. Prospective Review of 80 Patients from the Manchester Ortho-Plastic Unit

J Orthop. 2020 Jan 11:18:261-266. doi: 10.1016/j.jor.2020.01.012. eCollection 2020 Mar-Apr.

Authors

Affiliations

¹ Trauma and Orthopaedics, Manchester Foundation Trust, Southmoor Rd, Wythenshawe, Manchester, M23 9LT, UK.
² ST4 Spine Department, Royal Orthopaedic Hospital NHS Foundation Trust, Birmingham, B31 2AP, UK.
³ Plastic Surgery, Manchester Foundation Trust, Southmoor Rd, Wythenshawe, Manchester, M23 9LT, UK.

Abstract

Background: This study aims to evaluate outcomes of using Adjuvant Local Antibiotic Hydroxyapatite Bio-Composite in management of Open Gustilo-Anderson IIIB Fractures.

Methods and results: 80 patients were managed with single-stage "Fix and Flap" along with intra-operative Adjuvant Local Antibiotic Bio-Composite. Successful fracture union was achieved in 96.1% of patients, with a limb salvage rate of 96.25%. Infection rate was only 1.25%.

Conclusion: High union rate and very low deep infection rate can be predictably achieved in complex Open Gustilo-Anderson IIIB fractures by meticulous technique, use of local adjunctive antibiotics bio-composite and a combined ortho-plastic approach.

Keywords: Cerament G; Fix and flap; Gustilo anderson; Local antibiotics; Open fracture; Orthoplastic.