THE TREATMENT OF INFECTED NONUNIONS WITH GENTAMICIN POLYMETHYLMETHACRYLATE ANTIBIOTIC BEADS

Fifty-two patients enrolled in the Septopal study of infected nonunion s were prospectively examined in a randomized, controlled, closed stud y. Patients were divided into two groups. Group 1 consisted of 24 pati ents treated with debridement and intravenous antibiotics for four wee ks. Group 2 consisted of 28 patients treated with debridement, gentami cin-polymethylmethacrylate (Septopal) beads, and perioperative broad-s pectrum parenteral antibiotics. Both groups were treated with similar methods for reconstruction of the nonunions. The demographics of the t wo groups were similar. The average patient age in Group 1 was 38.4 ye ars, and in Group 2, 37.1 years. Group 1 included 21 men and three wom en and Group 2, 23 men and five women. The nonunions in both groups ra nged from simple hypertrophic nonunions to atrophic unions to segmenta l defects. The end results were good in both groups. Twenty patients i n Group 1 and 25 patients in Group 2 had their infections successfully arrested (83.3% and 89.3%, respectively). Nonunions were successfully healed in the two groups, with similar results (Group 1, 83.3%; Group 2, 85.7%). Infected nonunions responded equally well to either system ic treatment with long-term intravenous antibiotics or local treatment with gentamicin-polymethylmethacrylate beads.