Custom-Made Antibiotic Cement Nails in Orthopaedic Trauma: Review of Outcomes, New Approaches, and Perspectives

Table 2

The benefits and drawbacks of antibiotic cement nails.

Benefits

Drawbacks

High concentration of local antibiotic elution: up to 200 times greater than with systemic drug administration, independent of vascular supply [21]; Stability to the fracture/nonunion site, allowing for early weight bearing [23]; Local antibiotic delivery independent of patient compliance [23]; Systemic toxicity of antibiotics very rarely observed [8]; Versatility of modifying antibiotic as per the culture report [27]; Control of infection and stability is achieved with a single procedure [44]; Alternative for patients refusing or not being right candidates for external fixation [13]

Local antibiotic carriers have never been shown to be superior to intravenous administration of antibiotics in terms of cure rate [21]; Require repeat surgery [23]; Possible emergence of resistance [13]; Possible MMA toxicity [102, 103]