Background: Antibiotic loaded cement spacers are the gold standard in managing infected hemi or total hip arthroplasty in many centers. In our study, we applied the principles of antibiotic loaded spacers in a different indication with a relatively new, economic and reproducible method.
Patients & Methods: Between June 2012 and September 2013 we used the new idea in managing 13 cases of infection (5 cases) and open fractures (8 cases) in the lower limb. After thorough debridement of the infected bone or neat tissue cleaning in open fracture we were always left with a gap. The idea is to put the cement in a 50 ml syringe in the doughy state where a Steinmann pin is in the core. We tailored the length of the spacer according to the left gap guided by the graded syringe; 3-4 grams of vancomycin were put in an already loaded gentamycin cement pack.
Results: We succeeded in having a clean field in 11 cases where we proceeded to a final reconstruction, 2 cases (infection) needed further debridement and re-application of the spacer for more 6 weeks but at the end the laboratory tests were negative and reconstruction took over.
Conclusion: The new economic application of the antibiotic loaded cement spacer could be a solution for developing areas to cut short the budget other than the expensive ready-made spacers or beads.