To evaluate the efficacy of antibiotic-coated intramedullary locking nail in the open tibia fractures

Abstract

Aim: The purpose of this study was to evaluate the efficacy of antibiotic-coated intramedullary locking nail in the open tibia fractures. Materials and Methods: This prospective observational study was carried out in the Department of orthopaedic, NMCH Patna Bihar India for 1 year. Total 80 patients were treated with gentamicin coated tibia interlocking nail. Patients with Open fractures gustillo type 1, 2, 3A fracture were include in this study. Radiological Union was assessed using RUST Score and clinical assessment results were graded as excellent, good, fair and poor. Result: out of 80 patients 46.25% between 26-40 years of age, 28.75% of the patients between 41-55 years of age and 16.5% above 55years and 8.75% of patients below 25 years. Males were 75% against females 25% (Table 3). Time taken in wound healing in majority of patients was less than 6 weeks 42 (52.5%), 6-8 weeks 26(32.5%) , 8-10 weeks 7(8.75%) and  those were not healed 5(6.25%) . Majority of patents (56.25%) had RUST score 9 at six months of duration, 22.5% of patients had RUSH score 11 and 8.75% patients RUSH score was 6 at six months. 7 cases got infected in this study and in 4 case there was non union. Average duration of hospital stay was 15 days. Large numbers of patients had fair outcome 56.25%. Average time of wound healing in our study was 4.20 weeks. Out of 80 patients, fracture union was achieved in 78 (97.5%) patients and two patient (2.5%) patient undergone non unions. Conclusion: Implant related infection pose an important challenge in the surgical treatment of tibia shaft fracture. Local administration of antibiotics might minimize the risk of infection.

Keywords: RUST, RUSH, study.