Abstract
Implant-associated infections still represent one of the main problems in treatment of open fracture. The role of systemic antibiotic prophylaxis is now agreed and accepted; however, recent literature seems to underline the importance of local antibiotic therapy at the fracture site, and antibiotic nails have been shown to play a role in the treatment of open fractures in terms of fracture healing and lower risk of infection. We retrospectively analyzed our results, from January 2016 to March 2020, with the use of coated nails in the treatment of open tibial fractures, evaluating the rates of infection and fracture healing as primary outcomes and the rate of reoperations, time from trauma to nailing and hospital stay as secondary outcomes. Thirty-eight patients treated with coated nail (ETN ProtectTM, Synthes) were included in the study. Minimum follow-up was of 18 months. Thirty-four of 38 patients achieved bone union and 2 patients underwent septic non-union. In our series, no systemic toxicity or local hypersensitivity to antibiotics were recorded. From this study, use of antibiotic-coated nails appears to be a valid and safe option for treatment of open tibial fractures and prevention of implant-related infections, particularly in tibial fractures with severe soft tissue exposure and impairment.
Highlights
Implant-associated infections still represent a problem for Orthopedic and Trauma surgery
The aim of this study was to evaluate the results obtained in patients with open tibial fracture treated with a gentamicin-coated nails (ETN PROtectTM, DePuy Synthes) [22] in terms of bone and soft tissue healing rate, infection rate, reoperation rate and hospital stay
Patients who met the following inclusion criteria were enrolled in the study: open tibial fractures treated with antibiotic-coated nail (ETN PROtectTM, DePuy Synthes), with at least 18 months of clinical and radiographic follow-up and who had signed informed consent to treatment
Summary
Implant-associated infections still represent a problem for Orthopedic and Trauma surgery. Elective orthopedic surgery usually has a low infection rate (0.7–4.2%) [1]; in Trauma surgery this rate is higher with incidence rates between 3.6 and 8.1% in patients with closed fractures and between 5 and 33% in cases of open fractures [2,3]. Due to specific anatomical features, such as poor soft tissue coverage, poor vascularization, high-energy traumatic mechanism, bone comminution with frequent open fractures, infections are common in tibial fractures [8]. In this bone segment, open fractures showed the highest infection rate (8.8%) compared to closed fractures, where the rate reaches 2% [9]
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
