Clinical and radiological assessment of the prophylactic use of antibiotic coated intramedullary nail in treatment of open tibia fractures in adults

Abstract

Aim: To assess the outcome of prophylactic use of antibiotic coated intramedullary nail in treatment of open tibia fractures. Materials and Methods: 50 patients were selected with open fracture of shaft tibia, treated operatively with antibiotic coated intramedullary interlocking nail and were followed up for a minimum of four months duration. Radiological Union was assessed using RUST Score and clinical assessment results were graded as excellent, good, fair and poor. Result: In this study all 50 patients (35 males and 15 females) were followed up for a minimum of four months duration. The mean age of the study population was 35.5 years. Males were 70% against females 30% .The most common cause of injury was found to be due to road traffic accidents and accounted for 78% of cases. Fibula fracture was associated with 92% of patients. Time taken in wound healing in majority of patients was less than 4 weeks 27 (54%), 4-6 weeks 32% , 6-8 weeks 8% and  those were not healed 6% .Majority of patents (56%) had RUST score 10 at four months of duration, Large numbers of patients had fair outcome- 56%. Average time of wound healing in our study was 4.1 weeks.Conclusion: The use of the antibiotic coated nail has good clinical and radiological outcome at six months and preliminary results support the use of antibiotic coated implants as a new potential treatment option for prevention of infection in open tibia fractures.

Keywords: RUST score,intramedullary nail, clinical assessment, antibiotic coating