Deepak Pinto,K. Manjunatha,Amarnath D. Savur,Naufal Rizwan Ahmed,Sharan Mallya,V. Ramya.[J].中华创伤杂志英文版,2019,22(5):270-273
Comparative study of the efficacy of gentamicin-coated intramedullary interlocking nail versus regular intramedullary interlocking nail in Gustilo type I and II open tibia fractures
  
DOI:
KeyWord: Antibiotic impregnated nailIntramedullary nailingOpen tibia fractureInfection
FundProject:
Author NameAffiliation
Deepak Pinto Department of Orthopaedics, Kasturba Medical College Mangalore, Manipal Academy of Higher Education, India 
K. Manjunatha Department of Orthopaedics, Kasturba Medical College Mangalore, Manipal Academy of Higher Education, India 
Amarnath D. Savur Department of Orthopaedics, Kasturba Medical College Mangalore, Manipal Academy of Higher Education, India 
Naufal Rizwan Ahmed Department of Orthopaedics, Kasturba Medical College Mangalore, Manipal Academy of Higher Education, India 
Sharan Mallya Department of Orthopaedics, Kasturba Medical College Mangalore, Manipal Academy of Higher Education, India 
V. Ramya Department of Community Medicine, Basaveshwara Medical College, Chitradurga, India 
Hits:
Download times:
Abstract:
      Purpose: Open tibia fracture is prone to infection, consequently causing significant morbidity and increasing the hospital stay, occupational loss and onset of chronic osteomyelitis. Intramedullary nailing is one choice for treating tibia shaft fractures. To improve the delivery of antibiotics at the tissue-implant interface, many methods have been proposed as a part of prophylaxis against infection. This study was conducted to study the role of gentamicin-impregnated intramedullary interlocking (IMIL) nail in the prevention of infection in Gustilo type I and II open tibia fractures and to compare the results with regular intramedullary nail. Methods: The study included 28 patients with open tibia fractures (Gustilo type 1 or type 2); of them 14 underwent 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 unpaired t-test. A p value less than 0.05 was considered significant. Results: There were 4 cases of infection in controls (regular IMIL nail) and no infection among patients treated with gentamicin-coated nail during the follow up (X2 = 4.66, p = 0.031). At 6 months post operatively, CRP (p = 0.031), ESR (p = 0.046) and hemoglobin level (p = 0.016) showed significant dif ference between two groups. The bone healing rate was better with gentamicin-coated nail in comparison to regular IMIL nail at 6 months follow-up (p = 0.016). Conclusion: Gentamicin-coated IMIL nail has a positive role in preventing infection in Gustilo type I and II open tibia fractures.
View Full Text   View/Add Comment  Download reader
Close