Infection resistance of unreamed solid, hollow slotted and cannulated intramedullary nails: An in‐vivo experimental comparison

Horn, Joachim; Schlegel, U.; Krettek, Christian; Ito, Keita

doi:10.1016/j.orthres.2004.11.006

Cited by 38 publications

(17 citation statements)

References 30 publications

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“…There were 5 (15.5%) Klebsiella positive cases, 5 gram negative Bactria (15.5%), two cases of Staphylococcus aureus (6.5%), and 4 cases of coagulase-negative staphylococci (12.5%) in the studied sample [8][9][10] These findings are inconsistent with the results of some previous study. In one study, common infecting bacteria were staphylococcus aureus; while in another study, the most common isolated bacteria was Escherichia coli, and coagulasenegative staphylococci in the other.…”

Section: Resultscontrasting

confidence: 57%

Microbial Isolates in Early Swabs of Patients With Lower Limb Open Fractures

Omrani

Darestan

Emami-Moghadam-Tehrani

et al. 2012

nova-jmbs

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Fracture of lower limb is one of the most common orthopedic problems in emergency department. These fractures and particularly the open fractures have complications that among them, infection is most important and dangerous because lead to defect in functional outcomes of limb. Based on above mentioned; in this study we isolate and identified types of microbial that cause infection in lower limb's open fractures. In this cross sectional study, 32 patients with open lower limb fractures were enrolled. Open fracture's specimens were collected by swab and sent to the laboratory for microbial culture immediately. Then patients were compared based on type of isolated microbial contaminant and results of antibiogram. The most frequent was Klebsiella (15.5%), Gram negative bacteria (15.5%), negative coagulase Staphylococcus (12.5%), Staphylococcus Aurous (6.5%). Keywords: Fracture, Infection, Culture, BacteriaIntroduction Given the importance of infection in open fractures, prevention and treatment is of outmost important. There are many different factors that involved in the infection of open fractures, the most known factors are: Lack of prophylactic antibiotics, wound growth's resistance to antibiotics, the prolonged duration between injuries and antibiotic therapy, the extent of tissue damage. In general, it can be assumed that the most common and most important early complication of open fracture wounds is infection; thus necessary measures to deal properly with these type of injuries should be considered promptly [1][2][3][4]. Therefore, in the current study we decided to isolate and identifying common contaminating organisms in the open fracture's wounds through out of specimen's culture, in order to selecting the most effective antibiotics for prevention and treatment of these infections. Method; This was a cross sectional qualitative study conducted at Shahid Rajai hospital in the Tonkabon, between 86 to 87 periods. Patients with open fractures of the lower extremities whom visited the emergency department were included in the study. Bacterial cultures specimens were sent to laboratory. The patient's demographic Information were collected through checklist including age, sex, and microbial culture results. Patients compared based on the contaminated isolates and antibiogram results. Data were analyzed using SPSS software twentieth edition. P <0.05 was considered statistically significant [5][6][7].

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Section: Resultscontrasting

confidence: 57%

Microbial Isolates in Early Swabs of Patients With Lower Limb Open Fractures

Omrani

Darestan

Emami-Moghadam-Tehrani

et al. 2012

nova-jmbs

View full text Add to dashboard Cite

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“…The proponents of unreamed nails state that they are faster to insert and have results comparable to reamed nails [5,7]. Furthermore, preclinical data suggest that unreamed, solid core, nails are less susceptible to infection [31]. Comparative studies of both techniques have yielded conflicting results regarding outcomes [5,7,25,26,32].…”

Section: Discussionmentioning

confidence: 99%

Risk factors for nonunion after intramedullary nailing of femoral shaft fractures: Remaining controversies

Metsemakers

Roels

Belmans

et al. 2015

Injury

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Fracture stabilisation with IMN is a good treatment option for femoral shaft fractures in adults. The purpose of this study was to evaluate risk factors of poor outcome after IMN of femoral shaft fractures. The present analysis revealed that there was no difference in the outcome whether the fracture was reamed or not. Univariate and multivariate analysis could only correlate AO/OTA fracture type with the occurrence of nonunion. Therefore, in this study, unreamed nailing and damage control EF were not associated with a negative outcome.

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“…In recent literature a few studies are available, which give hints that solid nails are more resistant against infection compared with cannulated nails [10]. These studies are based only on animal experiences, but there exist no information about the differences of solid and cannulated nails in clinical use.…”

Section: Discussionmentioning

confidence: 99%

The use of gentamicin-coated nails in the tibia: preliminary results of a prospective study

Fuchs

Stange

Schmidmaier

et al. 2011

Arch Orthop Trauma Surg

175

130

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BackgroundThe use of antibiotic-coated implants may reduce the rate of infection and facilitate fracture healing after surgical treatment of tibial shaft fractures. A new biodegradable gentamicin-loaded coating of an implant (UTN PROtect®) was CE-certified in August 2005. In this prospective, non-randomized case series, we investigated the clinical, laboratory and radiological outcomes of 21 patients who underwent surgical treatment in closed or open tibial fractures, as well as revisions with the UTN PROtect® gentamicin-coated intramedullary nail.MethodsOf 21 patients (13 men, 8 women), 19 completed the 6-month follow-up. The study population included patients with complex tibial fractures and late revision cases. Clinical outcomes comprised adverse events, including infections and the SF-36 physical score. Laboratory outcomes, including C-reactive protein and leukocyte count as inflammatory markers, haemoglobin and serum gentamicin, were measured at baseline and up to 6 months post operatively. Radiographic assessments of fracture healing and weight-bearing capacity were determined at 5 weeks, 3 and 6 months after surgery.ResultsNo implant-related infections occurred; one patient had superficial wound healing problems. Mean C-reactive protein levels remained below 5 mg/L throughout the study, with a peak at 4–7 days after surgery (4.4 mg/L; range 0.5–16.1 mg/L). Leukocyte counts and haemoglobin levels did not vary over time during the study. The mean SF-36 physical score at 6 months was 42.6 (range 19.4–56.7). Radiographic union defined as three or four bridged cortices was achieved in 11 patients (58%) after 6 months. The remaining eight patients showed partial fracture healing with one or two bridged cortices. Additionally, 13 patients (68%) demonstrated full weight-bearing capacity after 6 months.ConclusionsThe use of the UTN PROtect® intramedullary nail was associated with good clinical, laboratory and radiological outcomes after 6 months. These preliminary results support the use of gentamicin-coated implants as a new potential treatment option for the prevention of infection in trauma patients and in revision cases.Level of EvidenceLevel II.

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Infection resistance of unreamed solid, hollow slotted and cannulated intramedullary nails: An in‐vivo experimental comparison

Cited by 38 publications

References 30 publications

Microbial Isolates in Early Swabs of Patients With Lower Limb Open Fractures

Microbial Isolates in Early Swabs of Patients With Lower Limb Open Fractures

Risk factors for nonunion after intramedullary nailing of femoral shaft fractures: Remaining controversies

The use of gentamicin-coated nails in the tibia: preliminary results of a prospective study

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