Treatment of Acute , Subacute and Chronic Osteomyelitis by Using Antibiotic-impregnated Bone Cement Beads

Osteomyelitis has always been a clinical dilemma in respect of resistance to treatment and frequent liability of recurrence. 60 cases of osteomyelitis, from 44 patients have been treated by antibiotic-impregnated cement beads technique in Kyung pook National University Hospital, Daegu, Korea. between 1986 and 1991. This paper was aimed at evaluating its effectiveness by clinical observation and analysis of those cases after minimum ten months of follow up and the following satisfactory results were obtained. l. As a cause of osteomylitis, chronic recurrent and postoperative infection was most common in each 14 patients, followed by open fractre in 11, acute hematogenous in 4 and Brodies abscess in l. 2. Antibiotics were selected according to the sentibity result. In 40 cases, single antibiotics (ex; Gentamicin, Gefamandole, ets) were used and in 20 cases, two antibiotics (Cephalosporin, Aminoglycoside) were combined in a single mixture. 3. The frequency of beads insertion was 1.4 times per case in average ranging from 1 time to 4 times. And the duration of beads insertion was 37days in average. 4. Number of inserted beads per case was averaging 30. 5. Pus drainage was stopped in 28 cases with one time of beads insertion, in 2 cases with two and 2 cases with three. 6. In 15 patients, autogenous iliac bone graft was performed and the result was satisfactory without recurrence. Therefore, when the lesion looks clean without pus, immediated bone graft could be a recommendable method.