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  

作　　者：Deepak Pinto K.Manjunatha Amarnath D.Savur Naufal Rizwan Ahmed Sharan Mally V.Ramya 

机构地区：[1]Department of Orthopaedics,Kasturba Medical College Mangalore,Manipal Academy of Higher Education,India [2]Department of Community Medicine,Basaveshwara Medical College,Chitradurga,India

出　　处：《Chinese Journal of Traumatology》2019年第5期270-273,共4页中华创伤杂志（英文版）

摘　　要：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 typeⅠandⅡopen 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),hemoglobin 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(Х^2=4.66,p=0.031).At 6 months postoperatively,CRP(p=0.031),ESR(p=0.046)and hemoglobin level(p=0.016)showed significant difference 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 typeⅠandⅡopen tibia fractures.

关 键 词：Antibiotic impregnated NAIL INTRAMEDULLARY NAILING OPEN TIBIA fracture Infection 

分 类 号：R[医药卫生]