{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,3]],"date-time":"2026-06-03T12:46:33Z","timestamp":1780490793342,"version":"3.54.1"},"reference-count":32,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2021,8,19]],"date-time":"2021-08-19T00:00:00Z","timestamp":1629331200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2021,8,19]],"date-time":"2021-08-19T00:00:00Z","timestamp":1629331200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"name":"The Key research and development program of China","award":["2016YFC1102005"],"award-info":[{"award-number":["2016YFC1102005"]}]},{"name":"The Key research and development program of China","award":["2016YFC1102005"],"award-info":[{"award-number":["2016YFC1102005"]}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Sci Rep"],"abstract":"<jats:title>Abstract<\/jats:title><jats:p>An internal fixation composite structure of antibiotic cement plates was created. The aim of this study was to analyse the infection control effect of this structure when applied to treat a bone infection. We retrospectively analysed patients with bone infection admitted to our hospital between January 2013 and June 2019. After debridement, an antibiotic cement plate composite structure was used to fill and stabilize the defects. The treatment effect was evaluated at six months after surgery, and the infection control rate, factors associated with the recurrence of infection, and complications were analysed. If the patients had bone defects, the defect was repaired after infection control, and the infection control rate of all of the patients was re-evaluated at 12\u00a0months after surgery. A total of 548 patients were treated with this technique, including 418 men and 130 women. The infection sites included 309 tibias, 207 femurs, 16 radii and ulnae, 13 humeri, and 3 clavicles. After at least 6\u00a0months of follow-up, 92 patients (16.79%) had an infection recurrence and needed further treatment. The recurrence rate of the tibia was higher than that of the femur (<jats:italic>P<\/jats:italic>\u2009=\u20090.025). Eighty-nine out of 92 patients who relapsed underwent a second debridement with the same method, and the infection control rate after the second debridement was 94.71%. Complications included 8 cases of epidermal necrosis around the incision, 6 cases of internal fixation failure, and 30 cases of lower limb swelling. By the follow-up time of 12\u00a0months, another 6 patients had experienced recurrence of infection, and 4 cases were controlled after debridement. Finally, among all 548 cases, 7 patients remained persistently infected, and 6 underwent amputation. The infection control rate was 97.6% at the 1-year follow-up. The clinical efficacy of this new antibiotic cement plate composite structure for internal fixation after debridement of bone infection is stable and reliable.<\/jats:p>","DOI":"10.1038\/s41598-021-96522-1","type":"journal-article","created":{"date-parts":[[2021,8,19]],"date-time":"2021-08-19T10:30:05Z","timestamp":1629369005000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":11,"title":["Antibiotic cement plate composite structure internal fixation after debridement of bone infection"],"prefix":"10.1038","volume":"11","author":[{"given":"Xiaohua","family":"Wang","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shulin","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jianzhong","family":"Xu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dong","family":"Sun","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jie","family":"Shen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhao","family":"Xie","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2021,8,19]]},"reference":[{"issue":"1","key":"96522_CR1","doi-asserted-by":"publisher","first-page":"442","DOI":"10.1186\/s12891-018-2363-5","volume":"19","author":"Z Zhang","year":"2018","unstructured":"Zhang, Z. et al. Infection-free rates and Sequelae predict factors in bone transportation for infected tibia: A systematic review and meta-analysis. BMC Musculoskelet. Disord. 19(1), 442 (2018).","journal-title":"BMC Musculoskelet. Disord."},{"issue":"10","key":"96522_CR2","doi-asserted-by":"publisher","first-page":"S105","DOI":"10.5435\/00124635-200600001-00025","volume":"14","author":"G Cierny 3rd","year":"2006","unstructured":"Cierny, G. 3rd. & Di Pasquale, D. Treatment of chronic infection. J. Am. Acad. Orthop. Surg. 14(10), S105-110 (2006).","journal-title":"J. Am. Acad. Orthop. Surg."},{"issue":"1","key":"96522_CR3","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1186\/s12891-016-1361-8","volume":"18","author":"X Wang","year":"2017","unstructured":"Wang, X. et al. Induced membrane technique for the treatment of chronic hematogenous tibia osteomyelitis. BMC Musculoskeletal. Disord. 18(1), 1\u20137 (2017).","journal-title":"BMC Musculoskeletal. Disord."},{"issue":"5","key":"96522_CR4","doi-asserted-by":"publisher","first-page":"1157","DOI":"10.1007\/s00264-017-3684-y","volume":"42","author":"Y Zhang","year":"2018","unstructured":"Zhang, Y. et al. Double-level bone transport for large post-traumatic tibial bone defects: A single centre experience of sixteen cases. Int. Orthop. 42(5), 1157\u20131164 (2018).","journal-title":"Int. Orthop."},{"issue":"2","key":"96522_CR5","doi-asserted-by":"publisher","first-page":"183","DOI":"10.2106\/JBJS.G.00306","volume":"89","author":"L Eralp","year":"2007","unstructured":"Eralp, L., Kocaoglu, M. & Rashid, H. Reconstruction of segmental bone defects due to chronic osteomyelitis with use of an external fixator and an intramedullary nail. Surgical technique. J. Bone Joint Surg. Am. 89(2), 183\u2013195 (2007).","journal-title":"J. Bone Joint Surg. Am."},{"issue":"2","key":"96522_CR6","doi-asserted-by":"publisher","first-page":"76","DOI":"10.1097\/00005131-200002000-00002","volume":"14","author":"D Paley","year":"2000","unstructured":"Paley, D. & Maar, D. C. Ilizarov bone transport treatment for tibial defects. J. Orthop. Trauma 14(2), 76\u201385 (2000).","journal-title":"J. Orthop. Trauma"},{"issue":"6","key":"96522_CR7","doi-asserted-by":"publisher","first-page":"1353","DOI":"10.1016\/j.injury.2016.03.010","volume":"47","author":"JA Scolaro","year":"2016","unstructured":"Scolaro, J. A. & Mehta, S. Stabilisation of infected peri-articular nonunions with an antibiotic impregnated cement coated locking plate: Technique and indications. Injury 47(6), 1353\u20131356 (2016).","journal-title":"Injury"},{"issue":"2","key":"96522_CR8","first-page":"E49","volume":"44","author":"JD Conway","year":"2015","unstructured":"Conway, J. D., Hlad, L. M. & Bark, S. E. Antibiotic cement-coated plates for management of infected fractures. Am. J. Orthop. 44(2), E49-53 (2015).","journal-title":"Am. J. Orthop."},{"issue":"2","key":"96522_CR9","doi-asserted-by":"publisher","first-page":"307","DOI":"10.1016\/j.injury.2019.11.026","volume":"51","author":"X Wang","year":"2020","unstructured":"Wang, X. et al. Risk factors associated with recurrence of extremity osteomyelitis treated with the induced membrane technique. Injury 51(2), 307\u2013311 (2020).","journal-title":"Injury"},{"key":"96522_CR10","first-page":"1821","volume":"41","author":"X Yu","year":"2016","unstructured":"Yu, X. et al. Antibiotic cement-coated locking plate as a temporary internal fixator for femoral osteomyelitis defects. Int. Orthop. 41, 1821\u20131857 (2016).","journal-title":"Int. Orthop."},{"issue":"7","key":"96522_CR11","doi-asserted-by":"publisher","first-page":"1623","DOI":"10.1016\/j.injury.2017.04.052","volume":"48","author":"F Luo","year":"2017","unstructured":"Luo, F. et al. Induced membrane technique combined with two-stage internal fixation for the treatment of tibial osteomyelitis defects. Injury 48(7), 1623\u20131627 (2017).","journal-title":"Injury"},{"issue":"1","key":"96522_CR12","doi-asserted-by":"publisher","first-page":"44","DOI":"10.1186\/s13018-020-1574-2","volume":"15","author":"C Jia","year":"2020","unstructured":"Jia, C. et al. An antibiotic cement-coated locking plate as a temporary fixation for treatment of infected bone defects: A new method of stabilization. J. Orthop. Surg. Res. 15(1), 44 (2020).","journal-title":"J. Orthop. Surg. Res."},{"issue":"Suppl 5","key":"96522_CR13","doi-asserted-by":"publisher","first-page":"S18","DOI":"10.1016\/S0020-1383(11)70128-0","volume":"42","author":"G Mouzopoulos","year":"2011","unstructured":"Mouzopoulos, G. et al. Management of bone infections in adults: The surgeon\u2019s and microbiologist\u2019s perspectives. Injury 42(Suppl 5), S18-23 (2011).","journal-title":"Injury"},{"issue":"6","key":"96522_CR14","doi-asserted-by":"publisher","first-page":"539","DOI":"10.1016\/j.jinf.2006.11.011","volume":"54","author":"NG Daver","year":"2007","unstructured":"Daver, N. G. et al. Oral step-down therapy is comparable to intravenous therapy for Staphylococcus aureus osteomyelitis. J. Infect. 54(6), 539\u2013544 (2007).","journal-title":"J. Infect."},{"issue":"7","key":"96522_CR15","doi-asserted-by":"publisher","first-page":"e5","DOI":"10.2106\/JBJS.RVW.16.00095","volume":"5","author":"J Barger","year":"2017","unstructured":"Barger, J., Fragomen, A. T. & Rozbruch, S. R. Antibiotic-coated interlocking intramedullary nail for the treatment of long-bone osteomyelitis. JBJS Rev. 5(7), e5 (2017).","journal-title":"JBJS Rev."},{"issue":"Suppl 2","key":"96522_CR16","doi-asserted-by":"publisher","first-page":"S105","DOI":"10.1016\/j.injury.2006.04.016","volume":"37","author":"G Schmidmaier","year":"2006","unstructured":"Schmidmaier, G. et al. Prophylaxis and treatment of implant-related infections by antibiotic-coated implants: A review. Injury 37(Suppl 2), S105-112 (2006).","journal-title":"Injury"},{"issue":"4","key":"96522_CR17","doi-asserted-by":"publisher","first-page":"258","DOI":"10.1097\/BOT.0b013e31803ea9e6","volume":"21","author":"R Thonse","year":"2007","unstructured":"Thonse, R. & Conway, J. Antibiotic cement-coated interlocking nail for the treatment of infected nonunions and segmental bone defects. J. Orthop. Trauma 21(4), 258\u2013268 (2007).","journal-title":"J. Orthop. Trauma"},{"issue":"10","key":"96522_CR18","doi-asserted-by":"publisher","first-page":"945","DOI":"10.1007\/s00402-007-0315-x","volume":"127","author":"Z Qiang","year":"2007","unstructured":"Qiang, Z. et al. Use of antibiotic cement rod to treat intramedullary infection after nailing: Preliminary study in 19 patients. Arch. Orthop. Trauma Surg. 127(10), 945\u2013951 (2007).","journal-title":"Arch. Orthop. Trauma Surg."},{"issue":"Suppl 4","key":"96522_CR19","doi-asserted-by":"publisher","first-page":"163","DOI":"10.2106\/JBJS.H.00753","volume":"90","author":"R Thonse","year":"2008","unstructured":"Thonse, R. & Conway, J. D. Antibiotic cement-coated nails for the treatment of infected nonunions and segmental bone defects. J. Bone Joint Surg. Am. 90(Suppl 4), 163\u2013174 (2008).","journal-title":"J. Bone Joint Surg. Am."},{"issue":"2","key":"96522_CR20","doi-asserted-by":"publisher","first-page":"338","DOI":"10.1097\/01.TA.0000035093.56096.3C","volume":"55","author":"CE Chen","year":"2003","unstructured":"Chen, C. E. et al. Infection after intramedullary nailing of the femur. J. Trauma 55(2), 338\u2013344 (2003).","journal-title":"J. Trauma"},{"issue":"3","key":"96522_CR21","doi-asserted-by":"publisher","first-page":"1031","DOI":"10.1007\/s10856-009-3907-x","volume":"21","author":"TF Moriarty","year":"2010","unstructured":"Moriarty, T. F. et al. Infection in fracture fixation: Can we influence infection rates through implant design?. J. Mater. Sci. Mater. Med. 21(3), 1031\u20131035 (2010).","journal-title":"J. Mater. Sci. Mater. Med."},{"issue":"1","key":"96522_CR22","doi-asserted-by":"publisher","first-page":"360","DOI":"10.1186\/s12891-018-2285-2","volume":"19","author":"XS Qiu","year":"2018","unstructured":"Qiu, X. S. et al. Coating the plate with antibiotic cement to treat early infection after fracture fixation with retention of the implants: A technical note. BMC Musculoskelet. Disord. 19(1), 360 (2018).","journal-title":"BMC Musculoskelet. Disord."},{"key":"96522_CR23","doi-asserted-by":"publisher","first-page":"97","DOI":"10.1097\/00003086-199903000-00012","volume":"360","author":"G Cierny III","year":"1999","unstructured":"Cierny III G. Infected tibial nonunions (1981\u20131995). The evolution of change. Clin. Orthop. Relat. Res. 360, 97\u2013105 (1999).","journal-title":"Clin. Orthop. Relat. Res."},{"issue":"3","key":"96522_CR24","doi-asserted-by":"publisher","first-page":"595","DOI":"10.1016\/j.injury.2016.01.019","volume":"47","author":"WJ Metsemakers","year":"2016","unstructured":"Metsemakers, W. J. et al. Influence of implant properties and local delivery systems on the outcome in operative fracture care. Injury 47(3), 595\u2013604 (2016).","journal-title":"Injury"},{"issue":"6","key":"96522_CR25","doi-asserted-by":"publisher","first-page":"814","DOI":"10.1302\/0301-620X.97B6.33276","volume":"97","author":"D Bose","year":"2015","unstructured":"Bose, D. et al. Management of infected nonunion of the long bones by a multidisciplinary team. Bone Joint J. 97(6), 814\u2013817 (2015).","journal-title":"Bone Joint J."},{"issue":"3","key":"96522_CR26","doi-asserted-by":"publisher","first-page":"403","DOI":"10.1302\/0301-620X.83B3.0830403","volume":"83","author":"AH Simpson","year":"2001","unstructured":"Simpson, A. H., Deakin, M. & Latham, J. M. Chronic osteomyelitis. The effect of the extent of surgical resection on infection-free survival. J. Bone Joint Surg. Br. 83(3), 403\u2013407 (2001).","journal-title":"J. Bone Joint Surg. Br."},{"issue":"11","key":"96522_CR27","doi-asserted-by":"publisher","first-page":"1825","DOI":"10.2217\/fmb.15.100","volume":"10","author":"A Crousilles","year":"2015","unstructured":"Crousilles, A. et al. Which microbial factors really are important in Pseudomonas aeruginosa infections?. Future Microbiol. 10(11), 1825\u20131836 (2015).","journal-title":"Future Microbiol."},{"issue":"Suppl 5","key":"96522_CR28","doi-asserted-by":"publisher","first-page":"S47","DOI":"10.1097\/BOT.0000000000000987","volume":"31","author":"M McNally","year":"2017","unstructured":"McNally, M. et al. Ilizarov treatment protocols in the management of infected nonunion of the Tibia. J. Orthop. Trauma 31(Suppl 5), S47\u2013S54 (2017).","journal-title":"J. Orthop. Trauma"},{"issue":"12","key":"96522_CR29","doi-asserted-by":"publisher","first-page":"0144736","DOI":"10.1371\/journal.pone.0144736","volume":"10","author":"C Arias Arias","year":"2015","unstructured":"Arias Arias, C. et al. Differences in the clinical outcome of osteomyelitis by treating specialty: Orthopedics or infectology. PLoS ONE 10(12), 0144736 (2015).","journal-title":"PLoS ONE"},{"issue":"15","key":"96522_CR30","doi-asserted-by":"publisher","first-page":"1292","DOI":"10.2106\/JBJS.15.00894","volume":"98","author":"M Parkkinen","year":"2016","unstructured":"Parkkinen, M. et al. Risk factors for deep infection following plate fixation of proximal tibial fractures. J. Bone Joint Surg. Am. 98(15), 1292\u20131297 (2016).","journal-title":"J. Bone Joint Surg. Am."},{"issue":"3","key":"96522_CR31","doi-asserted-by":"publisher","first-page":"268","DOI":"10.1055\/s-2008-1054234","volume":"136","author":"C von Eiff","year":"1998","unstructured":"von Eiff, C. et al. Development of gentamicin-resistant small colony variants of S. aureus after implantation of gentamicin chains in osteomyelitis as a possible cause of recurrence. Z. Orthop. Ihre Grenzgeb. 136(3), 268\u2013271 (1998).","journal-title":"Z. Orthop. Ihre Grenzgeb."},{"key":"96522_CR32","doi-asserted-by":"publisher","first-page":"307","DOI":"10.1016\/j.injury.2019.11.026","volume":"51","author":"X Wang","year":"2020","unstructured":"Wang, X. et al. Risk factors associated with recurrence of extremity osteomyelitis treated with the induced membrane technique. Injury 51, 307\u2013311 (2020).","journal-title":"Injury"}],"container-title":["Scientific Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.nature.com\/articles\/s41598-021-96522-1.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.nature.com\/articles\/s41598-021-96522-1","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.nature.com\/articles\/s41598-021-96522-1.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,12,3]],"date-time":"2022-12-03T12:45:44Z","timestamp":1670071544000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.nature.com\/articles\/s41598-021-96522-1"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,8,19]]},"references-count":32,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2021,12]]}},"alternative-id":["96522"],"URL":"https:\/\/doi.org\/10.1038\/s41598-021-96522-1","relation":{},"ISSN":["2045-2322"],"issn-type":[{"value":"2045-2322","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,8,19]]},"assertion":[{"value":"16 December 2020","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"31 July 2021","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"19 August 2021","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"The authors declare no competing interests.","order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"16921"}}