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https://hdl.handle.net/20.500.14094/0100481874
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2024-06-03
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0100481874 (fulltext)
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メタデータID
0100481874
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open access
出版タイプ
Version of Record
タイトル
Treatment of Chronic Osteomyelitis of the Femur by Intramedullary Antibiotic Perfusion (iMAP): A Case Report
著者
Ooe, Keisuke ; Maruo, Akihiro ; Fukui, Tomoaki ; Muratsu, Hirotsugu ; Kuroda, Ryosuke ; Niikura, Takahiro
著者ID
A2091
研究者ID
1000020514623
KUID
https://kuid-rm-web.ofc.kobe-u.ac.jp/search/detail?systemId=346c887d8da368be520e17560c007669
著者名
Ooe, Keisuke
大江, 啓介
オオエ, ケイスケ
所属機関名
医学部附属病院
著者名
Maruo, Akihiro
著者ID
A2565
研究者ID
1000050437688
KUID
https://kuid-rm-web.ofc.kobe-u.ac.jp/search/detail?systemId=e4d816863b4d40e0520e17560c007669
著者名
Fukui, Tomoaki
福井, 友章
フクイ, トモアキ
所属機関名
医学部附属病院
著者名
Muratsu, Hirotsugu
著者ID
A0783
研究者ID
1000080379362
KUID
https://kuid-rm-web.ofc.kobe-u.ac.jp/search/detail?systemId=f51cbfc82378ae63520e17560c007669
著者名
Kuroda, Ryosuke
黒田, 良祐
クロダ, リョウスケ
所属機関名
医学研究科
著者ID
A1418
研究者ID
1000040448171
著者名
Niikura, Takahiro
新倉, 隆宏
ニイクラ, タカヒロ
所属機関名
医学研究科
収録物名
Journal of Orthopaedic Case Reports
巻(号)
11(12)
ページ
35-38
出版者
Indian Orthopaedic Research Group
刊行日
2021-12
公開日
2023-04-24
抄録
Introduction: Chronic osteomyelitis is difficult to cure definitively, because local areas are often covered with sequestrum and scar tissues with a poor blood flow; these may render systemic antibiotic administration ineffective. We present a case of chronic osteomyelitis that was successfully treated with continuous local antibiotic perfusion (CLAP) through an intramedullary antibiotic perfusion (iMAP) pin. Case Presentation:A 65-year-old man who suffered an episode of the right femoral osteomyelitis at the age of 15 years experienced a relapse at the age of 63 years. Systemic administration of antibiotics could not control the infection; thus, a surgery was performed. A bone marrow needle (i.e., an iMAP pin; diameter: 3 mm) was percutaneously inserted, from the front, distally and proximally to the cystic lesion in the distal femur. After washing through the iMAP pins, the pins were left indwelling. A closed drain tube was placed on the bone surface, which was close to the fistula of the bone marrow lesion. CLAP therapy was then initiated. Gentamicin was continuously infused through the iMAP pin at a rate of 2 mL/h and drained using the tube. Accordingly, 2.4 mg/mL, 1.2 mg/mL, and 1.2 mg/mL of gentamicin were administered for 4 days using two iMAP pins, for 5–8 days using two iMAP pins, and for 9–15 days using one iMAP pin, respectively, with a syringe pump. The iMAP pins and the drain tube were removed 15 days after the initiation of the CLAP therapy. The C-reactive protein level normalized 25 days postoperatively. The patient recovered full range of motion of the knee joint and recreational sports activity without recurrence of osteomyelitis for 5 years after the therapy. Conclusions: CLAP therapy allows local administration of a sufficient concentration of antibiotics and device removal after treatment is simple. This may be a novel treatment for chronic osteomyelitis.
キーワード
Chronic osteomyelitis
continuous local antibiotic perfusion
femur
gentamicin
intramedullary antibiotic perfusion
カテゴリ
医学研究科
医学部附属病院
学術雑誌論文
権利
© 2021 Journal of Orthopaedic Case Reports
Creative Commons Attribution-NonCommercial-ShareAlike 4.0 License
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資源タイプ
journal article
言語
English (英語)
ISSN
2250-0685
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eISSN
2321-3817
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関連情報
DOI
https://doi.org/10.13107/jocr.2021.v11.i12.2556
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