Articles: polymethyl-methacrylate-administration-dosage.
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Prospective cohort study. ⋯ 3.
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The use of local antibiotics for the prevention of infection in the setting of open fractures and as part of the treatment of osteomyelitis is well established. Antibiotics are most commonly incorporated into polymethylmethacrylate (PMMA) cement, which can then be formed into beads, moulded to fit a bone defect or used to coat a guide wire or IM nail. Newer delivery vehicles and techniques are being evaluated to improve upon these methods. ⋯ Indications, techniques, dosages, types of antibiotics, elution properties and pharmacokinetics are poorly defined in the clinical setting. The purpose of our manuscript is to review current strategies and provide practical tips for local application of antibiotics in orthopaedic trauma. We focus on delivery vehicles, types of antibiotics, dosage recommendations when mixed with PMMA and indications.
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Eur J Orthop Surg Tr · Aug 2015
ReviewAntibiotic-laden PMMA bead chains for the prevention of infection in compound fractures: current state of the art.
Antibiotic-laden PMMA bead chains are a valuable method of local antibiotic treatment in the prevention of infection in open fractures. When used in this setting, they provide high concentrations of broad-spectrum antibiotics to the area of the highest risk which may not be well perfused or reached by systemic antibiotics, while also eliminating dead space. In this article, the historical and current state of antibiotic-laden bead chains is discussed. ⋯ These bead chains can be sterilely prepared in the operating room or manufactured, and they maintain their elution and antimicrobial properties for a considerable time period. The bead chains also allow a high local concentration of antibiotics without risk of systemic toxicity or fear of clinically significant growth or persistence of bacteria on the beads. Bead chains are a practical method of local antibiotic therapy when the wounds can be closed.
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Observational Study
Percutaneous vertebroplasty combined with percutaneous pediculoplasty for lytic vertebral body and pedicle lesions of metastatic tumors.
Percutaneous pediculoplasty (PP) consists of the injection of Poly(methyl methacrylate) (PMMA) into the fractured pedicle or lytic vertebral pedicle lesions, as a technique derived from vertebroplasty. ⋯ PV and PP via the transpedicular approach for infiltrated vertebral bodies and infiltrated pedicles of metastatic tumors may be considered a valid therapeutic option.
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Although imaging plays a critical role and has become an integral part in preprocedure evaluation of osteoporotic patients at risk of compression fracture, many treated patients undergo follow-up imaging, for reasons ranging from potential procedure-related complications to development of new symptoms after initial improvement after successful vertebral augmentation (VA). Although imaging is frequently obtained for evaluation of these patients, there is a general lack of knowledge about imaging characteristics of treated vertebrae. This article reviews various indications for post-VA imaging, the appearance of augmented spine on imaging, and the important complications associated with the VA procedure.