Abstract

Background: Infected nonunions of the tibia pose significant challenges for complete resolution and functional restoration. local bone tissue remains without bactericidal concentrations, thus not interfering with bacterial growth.So acrylic bone cement is the gold standard for dead space management and the standard carrier for local antibiotic delivery in themanagement of orthopaedics infections. The aim of this study is to assess the outcome after treatment of infected non-unions of tibia treated by Antibiotic cement impregnated intramedullary nailing (ACIIMN).Patients and methods: This study included 12 cases with infected non union tibia were admitted to Orthopedic Surgery Department, Faculty of Medicine, Zagazig University Hospitals. The used methods of the study includes and preoperative evaluation, methods of treatment and postoperative follow up and methods of postoperative evaluation. All patients were followed-up, with an average follow-up time of 18 months. Results: Age was distributed as 44.66±9.48 and majority were male with 83.3% and DM was present in 25% of studied group. The mean duration of infection was 9.58±2.06. Union time was distributed as 32.33±6.44 weeks.  Only three cases needed additional method. The overall outcome showed 75% had successful union without any additional methods and 25% of our studied group had persistent infection. Unfavorable outcome significantly associated with higher age. Conclusion: Antibiotic cement impregnated nailing is a safe and simple and effective procedure than other methods in the management of infected nonunion of tibia. It is the best option that significantly reduce the union time without causing much problem. The method utilizes existing easily available instrumentation and materials and is technically less demanding at any orthopaedic center.