Journals / Medical Records / 2026 / Cilt: 7 Sayı: 2

The Use of Antibiotic-Impregnated Cement in the Surgical Treatment of Chronic Osteomyelitis in Children

Hakan Cici(İZMİR DEMOKRASİ ÜNİVERSİTESİ, TIP FAKÜLTESİ)0000-0002-9511-4865
Hakan Zeybek(İzmir Katip Çelebi Üniversitesi Atatürk Eğitim Araştırma Hastanesi)0000-0003-1525-9966
Osman Mohamed Abdulkarim(Mogadişu Somali Türkiye Recep Tayyip Erdoğan Eğitim ve Araştırma Hastanesi)0009-0006-7613-631X
Kazım Kıratlı(İzmir Katip Çelebi Üniversitesi Atatürk Eğitim Araştırma Hastanesi)0000-0001-8317-955X
Abdulkhalek Hassan Mohamed(Mogadişu Somali Türkiye Recep Tayyip Erdoğan Eğitim ve Araştırma Hastanesi)0009-0000-2067-9231
Gürkan Yıldız(İzmir Demokrasi Üniversitesi, Buca Seyfi Demirsoy Eğitim Araştırma Hastanesi)0000-0001-8471-4294
Pages
327–332
Publication Date
2025-05-09
🏛️Bibliographic metadata and full text access for this article are provided via DergiPark.
DergiPark Record ↗
✨

AI Summary & Key Takeaways

AI Insight
⚡ TL;DR(Too Long; Didn't Read)

Despite predictable complications, the application of antibiotic-impregnated cement may be effective in the context of providing infection eradication and bone union, which are the main treatment aims in this disease.

📌 3 Key Takeaways

🎯
Objective & Hypothesis:Aim: Information in the literature related to paediatric chronic osteomyelitis is extremely limited as the disease can be prevented to a large extent in developed countries.
📊
Key Findings & Data:Material and Method: Two-stage surgical debridement and antibiotic-impregnated cement was performed because of chronic osteomyelitis in 8 patients (6 males, 2 females) with a mean age of 6 years (range, 2-11 years) between June 2018 and June 2022.
💡
Conclusion & Impact:Despite predictable complications, the application of antibiotic-impregnated cement may be effective in the context of providing infection eradication and bone union, which are the main treatment aims in this disease.
🔬Design:Klinik Araştırma
📍Scope:2018 Verileri
⚙️Variables:Pediatric · chronic osteomyelitis · surgical treatment

Abstract

Aim: Information in the literature related to paediatric chronic osteomyelitis is extremely limited as the disease can be prevented to a large extent in developed countries. The aim of this study was to evaluate the clinical and radiological results of patients treated with two-stage surgical debridement and antibiotic-impregnated cement because of chronic osteomyelitis, and to thereby contribute to the literature. Material and Method: Two-stage surgical debridement and antibiotic-impregnated cement was performed because of chronic osteomyelitis in 8 patients (6 males, 2 females) with a mean age of 6 years (range, 2-11 years) between June 2018 and June 2022. Demographic data were recorded together with the time since the onset of symptoms, anatomic localisation, accompanying fractures, and laboratory parameters. Postoperatively, the patients were followed up in respect of infection recurrence, nephrotoxicity, and fracture healing with direct radiographs and laboratory tests. Results: The mean follow-up period was 19 months (range, 12-30 months). The localisation of chronic osteomyelitis was determined to be the femur in 2 (25%) patients, the tibia in 3 (37%), the humerus in 2 (25%), and the radius in 1 (12%). In 3 (37%) patients with no history of trauma, the diagnosis made on first evaluation was osteomyelitis-related pathological fracture. No recurrence of infection was observed in any patient during the follow-up period after the final surgery. Full bone union was observed in the cases with accompanying fracture, and of these, deformity was determined in 2 and mild contracture in 1. Conclusion: Paediatric chronic osteomyelitis can lead to severe problems of bone integrity, especially in cases which have been neglected or when presentation is delayed. Despite predictable complications, the application of antibiotic-impregnated cement may be effective in the context of providing infection eradication and bone union, which are the main treatment aims in this disease.

🔖

Cite This Article

Cici, H., Zeybek, H., Abdulkarim, O. M., Kıratlı, K., Mohamed, A. H., Yıldız, G. (2025). The Use of Antibiotic-Impregnated Cement in the Surgical Treatment of Chronic Osteomyelitis in Children. Medical Records, Cilt: 7 Sayı: 2, 327–332. https://doi.org/10.37990/medr.1614823

📄 Full Text PDF Viewer

📄

PDF görüntüleyici hazırlanıyor...

References (20)

  1. Dich VQ, Nelson JD, Haltalin KC. Osteomyelitis in infants and children. A review of 163 cases. Am J Dis Child. 1975;129:1273-8.
  2. Gornitzky AL, Kim AE, O'Donnell JM, Swarup I. Diagnosis and management of osteomyelitis in children: a critical analysis review. JBJS Rev. 2020;8:e1900202.
  3. Howard-Jones AR, Isaacs D. Systematic review of systemic antibiotic treatment for children with chronic and sub-acute pyogenic osteomyelitis. J Paediatr Child Health. 2010;46:736-41.
  4. Hsieh PH, Tai CL, Lee PC, Chang YH. Liquid gentamicin and vancomycin in bone cement: a potentially more cost-effective regimen. J Arthroplasty. 2009;24:125-30.
  5. Arnold JC, Bradley JS. Osteoarticular infections in children. Infect Dis Clin North Am. 2015;29:557-74.
  6. Jaramillo D, Dormans JP, Delgado J, et al. Hematogenous osteomyelitis in infants and children: imaging of a changing disease. Radiology. 2017;283:629-43.
  7. Howard JL, Buckley R, McCormack R, et al. Complications following management of displaced intra-articular calcaneal fractures: a prospective randomized trial comparing open reduction internal fixation with nonoperative management. J Orthop Trauma. 2003;17:241-9.
  8. Hollmig ST, Copley LA, Browne RH, et al. Deep venous thrombosis associated with osteomyelitis in children. J Bone Joint Surg Am. 2007;89:1517-23.
  9. Canavese F, Corradin M, Khan A, et al. Successful treatment of chronic osteomyelitis in children with debridement, antibiotic-laden cement spacer and bone graft substitute. Eur J Orthop Surg Traumatol. 2017;27:221-8.
  10. Paley D, Herzenberg JE. Intramedullary infections treated with antibiotic cement rods: preliminary results in nine cases. J Orthop Trauma. 2002;16:723-9.
  11. Bar-On E, Weigl DM, Bor N, et al. Chronic osteomyelitis in children: treatment by intramedullary reaming and antibiotic-impregnated cement rods. J Pediatr Orthop. 2010;30:508-13.
  12. Andreacchio A, Alberghina F, Paonessa M, et al. Tobramycin-impregnated calcium sulfate pellets for the treatment of chronic osteomyelitis in children and adolescents. J Pediatr Orthop B. 2019;28:189-95.
  13. Marais LC, Ferreira N. Bone transport through an induced membrane in the management of tibial bone defects resulting from chronic osteomyelitis. Strategies Trauma Limb Reconstr. 2015;10:27-33.
  14. Ferguson JY, Dudareva M, Riley ND, et al. The use of a biodegradable antibiotic-loaded calcium sulphate carrier containing tobramycin for the treatment of chronic osteomyelitis: a series of 195 cases. Bone Joint J. 2014;96-B:829-36.
  15. Jung J, Schmid NV, Kelm J, et al. Complications after spacer implantation in the treatment of hip joint infections. Int J Med Sci. 2009;6:265-73.
  16. Menge TJ, Koethe JR, Jenkins CA, et al. Acute kidney injury after placement of an antibiotic-impregnated cement spacer during revision total knee arthroplasty. J Arthroplasty. 2012;27:1221-7.
  17. Luu A, Syed F, Raman G, et al. Two-stage arthroplasty for prosthetic joint infection: a systematic review of acute kidney injury, systemic toxicity and infection control. J Arthroplasty. 2013;28:1490-8.
  18. Yeo A, Ramachandran M. Acute haematogenous osteomyelitis in children. BMJ. 2014;348:g66. Erratum in: BMJ. 2014;348:1326.
  19. Congedi S, Minotti C, Giaquinto C, et al. Acute infectious osteomyelitis in children: new treatment strategies for an old enemy. World J Pediatr. 2020;16:446-55.
  20. Saavedra-Lozano J, Mejías A, Ahmad N, et al. Changing trends in acute osteomyelitis in children: impact of methicillin-resistant Staphylococcus aureus infections. J Pediatr Orthop. 2008;28:569-75.