Removal of Antibiotic Cement-Coated Interlocking Nails.

Abstract

To report the outcomes of antibiotic cement-coated interlocking nail (ACCIN) removal, detail a removal technique that mitigates debonding of coating, and describe how to address occurrences intraoperatively. Retrospective case series. Level II trauma center. Twenty-eight patients who underwent ACCIN removal between January 2014 and August 2019. Removal of ACCINs that were coated using the silicone tubing method. Successful removal of the nail with intact antibiotic coating. A total of 42 ACCIN removals were included in this study. Successful ACCIN removal was achieved in 37 cases (88.1%), with debonding in only 5 cases (11.9%). Eight nails (19%) required 1 additional removal procedure, and 3 nails (7.1%) required 2 additional removal procedures. The main reasons for the additional procedures were nonunion and persistent infection. ACCIN insertion and removal can be challenging. The proper technique of coating and insertion can facilitate later removal. Removal of knee-long fusion rods can be more challenging. Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.