Slot Drainage Technique Combined with Drug-loaded Calcium Sulfate for Treating Postoperative Infections Following Intramedullary Nailing of Lower Limb Fractures

Shi Shouyin; Zhou Min; Hairati Baheti; Habaxi Kahn; Xu Jiangbo; Sun Jungang

Abstract：Objective To evaluate the clinical efficacy of slot drainage technique combined with drug-loaded calcium sulfate in treating postoperative infections following intramedullary nailing of lower limb fractures.Methods A retrospective analysis was conducted on 42 patients with postoperative infections after intramedullary nailing of lower limb fractures treated at the People's Hospital of Xinjiang Uygur Autonomous Region from June 2018 to June 2024.The cohort included 30 males and 12 females,aged 20～65 years[mean(35.0±3.0)years].Among them,15 cases involved femoral intramedullary nailing infections,and 27 cases involved tibial intramedullary nailing infections.The disease duration ranged from 3 to 10 months[mean(5.0±1.5)months].All patients were treated with slot drainage technique combined with drug-loaded calcium sulfate.Postoperative outcomes were comprehensively evaluated based on the time to resolution of clinical symptoms,normalization of infection markers(complete blood count,C-reactive protein,erythrocyte sedimentation rate,procalcitonin),radiographic findings,recurrence rate,and functional recovery.Results Postoperative follow-up ranged from 6 to 12 months[mean(10.0±1.5)months].Primary healing was achieved in 40 cases(95.2％),while 2 cases experienced recurrence but resolved after retreatment.The time to resolution of clinical symptoms postoperatively was 3～6 months[mean(4.0±0.5)months].Laboratory infection markers normalized within 3～7 months[mean(5.0±1.5)months],and radiographic recovery occurred within 5～10 months[mean(7.0±1.5)months).Functional recovery assessed by the Paley score was excellent in 34 cases(81.0％),good in 5 cases(11.9％),and fair in 3 cases(7.1％),with an excellent-to-good rate of 92.9％.Conclusion Slot drainage technique combined with drug-loaded calcium sulfate for postoperative infection after intramedullary nailing of lower limb fractures yields significant clinical results,low postoperative recurrence rate,markedly shortened fracture healing time,reduced antibiotic consumption,and lowered risk of drug toxicity,thus demonstrating clinical value for wider application.