Prophylactic use of antibiotic laden poly methyl methacrylate beads in the management of open fractures: a novel approach for control of orthopaedic infection

Hariprasad Seenappa, Prabhulingreddy Patil, Harsha Madamanchi, Sakthikesavan Sivanandan


Background: Control of infection in open fractures is a challenge in orthopaedic surgery. The literature provides evidence that antibiotic-laden bead chains are a useful adjuvant with systemic antibiotics in the prevention of infection in open fractures.

Methods: Between February 2018 and January 2019, sixty four patients with open type fractures admitted in emergency room were analysed for this study. In this 64 patients, 32 in Group A received antibiotic laden PMMA (Poly methyl methacrylate) beads with standard care. Another 32 in Group B received standard care.

Results: There were 54 males and 10 females with a mean age of 41 and follow up 6 months. Among 64 patients 37 patients were stabilised with external fixators and remaining 17 patients underwent a definitive fixation either an intramedullary nailing (12 patients) or internal fixation with a plate (5 patients). 10 patients were stabilised with k wires. The infection rate in group A and B was 6.25% and 21.8% respectively which is statistically not significant (p=0.072).

Conclusions: Although the final infection control rate was comparable between the bead group (30/32, 93.75%) and the non bead group (25/32, 78.12%), few complications were noted in the bead group (9.37%, 3/32) than in the group B (15.62%, 5/32). Hence the prophylactic use of antibiotic cement beads is advantageous in preventing post traumatic orthopaedic infection, lessens hospital stay as well the financial burden to the patients.


PMMA beads, Open fractures, Orthopaedic infection

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