Comparative study of the efficacy of gentamicin-coated intramedullaryinterlocking nail versus regular intramedullary interlocking nail in Gustilo type Iand II open tibia fractures

Pinto, Deepak and K, Manjunatha and Savur, Amarnath D and Rizwan Ahmed, Naufal and Mallya, Sharan and V, Ramya (2019) Comparative study of the efficacy of gentamicin-coated intramedullaryinterlocking nail versus regular intramedullary interlocking nail in Gustilo type Iand II open tibia fractures. Chinese Journal of Traumatology - English Edition, 22 (5). pp. 270-273. ISSN 10081275

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Abstract

Purpose:Open tibia fracture is prone to infection, consequently causing significant morbidity andincreasing the hospital stay, occupational loss and onset of chronic osteomyelitis. Intramedullary nailingis one choice for treating tibia shaft fractures. To improve the delivery of antibiotics at the tissue-implantinterface, many methods have been proposed as a part of prophylaxis against infection. This study wasconducted to study the role of gentamicin-impregnated intramedullary interlocking (IMIL) nail in theprevention of infection in Gustilo type I and II open tibia fractures and to compare the results withregular intramedullary nail.Methods:The study included 28 patients with open tibia fractures (Gustilo type 1 or type 2); of them 14underwent regular IMIL nailing and the other 14 were treated with gentamicin-coated nailing.Randomization was done by alternate allocation of the patients. Follow-up was done postoperatively(day 1), 1 week, 6 weeks, and 6 months for bone union, erythrocyte sedimentation rate (ESR), hemo-globin and C-reactive protein (CRP). Statistical significance was tested using unpairedt-test. Apvalue lessthan 0.05 was considered significant.Results:There were 4 cases of infection in controls (regular IMIL nail) and no infection among patientstreated with gentamicin-coated nail during the follow up (X2¼4.66,p¼0.031). At 6 months post-operatively, CRP (p¼0.031), ESR (p¼0.046) and hemoglobin level (p¼0.016) showed significant dif-ference between two groups. The bone healing rate was better with gentamicin-coated nail incomparison to regular IMIL nail at 6 months follow-up (p¼0.016).Conclusion:Gentamicin-coated IMIL nail has a positive role in preventing infection in Gustilo type I and IIopen tibia fractures.

Item Type: Article
Uncontrolled Keywords: Antibiotic impregnated nailIntramedullary nailingOpen tibia fractureInfection
Subjects: Medicine > KMC Mangalore > Orthopaedics
Depositing User: Admin KMCMLR
Date Deposited: 02 Dec 2019 11:22
Last Modified: 02 Dec 2019 11:22
URI: http://eprints.manipal.edu/id/eprint/154749

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