Presentation
Status three months post open reduction and internal fixation (ORIF) following a comminuted fracture the hand and forearm.
Patient Data
A volar reconstruction plate and stabilizing screws are noted at the radius. Multiple fractures can be seen throughout the radius, ulna, and third metacarpal with various degrees of callous formation. Throughout the dorsal surface of the hand and distributed circumferentially about the radius antibiotic-impregnated beads can be seen.
The bone density around the distal forearm and wrist appears decreased but is most likely attributed to disuse. There is no radiographic evidence of osteomyelitis or septic arthritis.
Case Discussion
The use of antibiotic impregnated cement beads creates a high local concentration of antibiotic that could not be achieved with systemic therapy 1. Many applications for these beads have been established some of which include prophylactic treatment of fractures with open wounds, infected hardware, and osteomyelitis.
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