Clinical applications of Bioactive glass S53P4 in bone infections: a systematic review.

OBJECTIVE: Treatment of osteomyelitis, in of itself, is challenging but is further complicated by attendant bone infections. The management of bone infection, and bone rebuilding may be assisted by the use of bioactive glasses (BAGs) which have antimicrobial and osteo-stimulative proprieties. However, this clinical application and potential complications associated with BAGs (e.g., BAG S53P4), are poorly defined. The aim of this study is to review the results of clinical research using BAG S53P4 in the treatment of human bone infections. MATERIALS AND METHODS: This review was conducted in accordance with the PRISMA statement. The following databases were searched: PubMed, Cochrane Library, EMBASE, and Scopus. We examined electronic databases from 1965 to 2018 using different combinations of the following keywords: "S53P4", "BonAlive", "infection" and "osteomyelitis". RESULTS: Eight studies were considered which included a total of 276 cases (mean age of 49.3 years). The most frequent pathogen isolated was Staphylococcus aureus. A one-step surgical procedure was performed in 89.85% of cases. Good clinical and radiological outcomes were reported with a mean follow-up of 21.5 months. Twenty-three complications (8.3% of total cases) were described with the recurrence of bone infection as the most common complication (6.15% of total cases). CONCLUSIONS: BAG-S53P4 seems to be a useful bone filler in orthopaedic surgery for osteomyelitis treatment. The attendant clinical results and associated rate of complications associated with BAG S53P4 use are comparable with those of other techniques in the short term. However, long-term follow-up studies are required in order to confirm the longevity of this treatment.

Distal humeral septic non-union treated with debridement and vascularized fibular transfer: case report and review of the literature.

Clinical management of a septic non-union of the distal humerus is challenging and is complicated by the diversity of potential treatments which are variably successful. We report a novel and very successful treatment of a 58-year-old man presenting an infected non-union of the right distal humerus, secondary to a closed fracture initially treated with two anatomic plates. After hardware removal, a two-stage reconstruction was performed. Bone and soft-tissue debridement was performed, followed by vascularized fibular transfer and free iliac bone crest chips fixed with plates and screws. Consolidation was achieved within three months, and a very good elbow function was presented two years thereafter. This technique shows great promise for improved management of large segmental infected bone defects of complete articular distal humeral fractures, above many currently recognized treatments.

[Surgical treatment of strabismus by sagittal cutting of the oblique muscles. Apropos of 449 cases]. / Traitement chirurgical du strabisme incomitant par sagittalisation des obliques. A propos de 449 cas.

The theoretical proposals and the therapeutic approach described at the beginning of the sixties by Gobin concerning the treatment of incomitant strabismus have had such positive results as to convince many surgeons to adopt this methodology. The principal merit of Gobin's technique lies in evaluation of all aspects of the strabismus (horizontal, vertical and oblique) searching for the obstacles to ocular movements which cause alteration of binocular vision and removing them. According to the above criteria, we have operated 449 cases of incomitant strabismus due to sagittalization of the oblique muscles. The validity of this technique has been demonstrated by the results obtained in a single operation (a success rate of over 50%). With a second operation the success rate was increased to 70% (orthophoria, heterophoria and esthetic angle < 7 degrees).