{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T13:17:34Z","timestamp":1791897454578,"version":"4.3.4"},"reference-count":37,"publisher":"SLACK, Inc.","issue":"5","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Orthopedics"],"published-print":{"date-parts":[[2009,5]]},"abstract":"<jats:p>This article presents our experience with the use of antibiotic-impregnated calcium sulfate in the management of comminuted open fractures with a bony defect caused by combat-related blast injuries and high-energy wounds.<\/jats:p>\n          <jats:p>Calcium sulfate was used 19 times in 15 patients (17 fractures) as a bone graft substitute and a carrier for antibiotics. The anatomic sites of the graft were as follows: 6 calcanei, 1 midfoot, 1 metatarsal, 5 tibiae, 3 femorae, and 1 humerus. The average number of procedures prior to grafting was 6.2 (range, 2\u201310; median, 6) with grafting performed at an average 28 days after injury (range, 9\u2013194 days; median, 14 days). Average radiographic follow-up of 12 fractures not requiring repeat grafting or amputation was 8.5 months (range 1\u201319 months; median, 7 months), and all of these fractures demonstrated clinical and radiographic evidence of fracture healing and consolidation. Four patients subsequently underwent 5 transtibial amputations: 2 for persistent infection, 1 when the patient changed his mind against limb salvage acutely, and 2 for severe neurogenic pain. Including the 2 amputations for persistent infection, 4 patients (22.2%) required further surgical management of infection. Three patients (17.6%) subsequently developed heterotopic ossification at the graft site, which required surgical excision.<\/jats:p>\n          <jats:p>Antibiotic-impregnated calcium sulfate is effective in treating severe, contaminated open fractures by reducing infection and assisting with fracture union.<\/jats:p>","DOI":"10.3928\/01477447-20090501-03","type":"journal-article","created":{"date-parts":[[2009,5,28]],"date-time":"2009-05-28T10:36:56Z","timestamp":1243507016000},"page":"323-328","source":"Crossref","is-referenced-by-count":46,"title":["Antibiotic-impregnated Calcium Sulfate Use in Combat-related Open Fractures"],"prefix":"10.3928","volume":"32","author":[{"given":"CPT Melvin D.","family":"Helgeson","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"MAJ Benjamin K.","family":"Potter","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"CPT Christopher J.","family":"Tucker","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"LTC H.","family":"Michael Frisch","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"LTC Scott B.","family":"Shawen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"2308","reference":[{"issue":"10","key":"e_1_3_1_2_2","first-page":"446","article-title":"Infection prevention and surgical management of deep insidious infection in total endoprosthesis [in German]","volume":"43","author":"Buchholz HW","year":"1972","unstructured":"Buchholz HW, Gartmann HD. 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