Removing a Retained Antibiotic Cement Nail from a Tibia: A Case Report.

Area of Science:

• Orthopedic Surgery
• Infectious Disease Management
• Biomaterials in Medicine

Background:

• Osteomyelitis is a serious bone infection often requiring surgical intervention.
• Antibiotic intramedullary rods are used to treat bone infections but can present removal challenges.
• Open tibial shaft fractures are complex injuries with a high risk of infection.

Observation:

• A case of osteomyelitis following a grade 3A open tibial shaft fracture is detailed.
• Complication arose from incomplete removal of a custom-fabricated antibiotic intramedullary rod.
• A retained cement mantle during rod extraction posed a significant surgical problem.

Findings:

• A novel technique for cement mantle removal was successfully employed.
• The technique involved a distal tibial corticotomy and antegrade cement impaction.
• This approach offers a solution for a previously unreported complication.

Implications:

• This case highlights potential intraoperative challenges with custom antibiotic rods.
• The described technique provides a viable solution for retained cement mantle removal.
• Improved management strategies for complex osteomyelitis cases can be developed.