What is the ideal composition of antibiotic-impregnated intramedullary (IM) nails?

Authors: Jorge Manrique, Francisco Reyes, Mustafa Citak, Carl Haasper, Charalampos Zalavras, Eduardo M. Suero, Gerson Amaris

RECOMMENDATION: The ideal composition of antibiotic-impregnated IM nails is unknown. The core should consist of a rigid structure such as an Ender’s IM nail, Ilizarov threaded rods, IM locked nails, carbon fiber nails or sectioned pins or guidewires. We recommend at least 2 grams of vancomycin and 2.4 grams of an aminoglycoside be added to each pack (40 grams) of polymethyl methacrylate cement. If a specific microorganism is isolated, targeted antibiotic therapy should be included.

LEVEL OF EVIDENCE: Consensus

DELEGATE VOTE: Agree: 86%, Disagree: 9%, Abstain: 5% (Super Majority, Strong Consensus)

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