Antibiotic-Coated Nail in Open Tibial Fracture: A Retrospective Case Series

Carlo Perisano; Tommaso Greco; Chiara Polichetti; Michele Inverso; Giulio Maccauro

doi:10.3390/jfmk6040097

Antibiotic-Coated Nail in Open Tibial Fracture: A Retrospective Case Series

J Funct Morphol Kinesiol. 2021 Nov 29;6(4):97. doi: 10.3390/jfmk6040097.

Authors

Carlo Perisano¹, Tommaso Greco^{1

2}, Chiara Polichetti^{1

2}, Michele Inverso^{1

2}, Giulio Maccauro^{1

2}

Affiliations

¹ Department of Ageing, Neurosciences, Head-Neck and Orthopedics Sciences, Orthopedics and Traumatology, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, 00168 Rome, Italy.
² Orthopedics and Traumatology, Università Cattolica del Sacro Cuore, 00168 Rome, Italy.

Abstract

Implant-associated infections still represent one of the main problems in treatment of open fracture. The role of systemic antibiotic prophylaxis is now agreed and accepted; however, recent literature seems to underline the importance of local antibiotic therapy at the fracture site, and antibiotic nails have been shown to play a role in the treatment of open fractures in terms of fracture healing and lower risk of infection. We retrospectively analyzed our results, from January 2016 to March 2020, with the use of coated nails in the treatment of open tibial fractures, evaluating the rates of infection and fracture healing as primary outcomes and the rate of reoperations, time from trauma to nailing and hospital stay as secondary outcomes. Thirty-eight patients treated with coated nail (ETN Protect^TM, Synthes) were included in the study. Minimum follow-up was of 18 months. Thirty-four of 38 patients achieved bone union and 2 patients underwent septic non-union. In our series, no systemic toxicity or local hypersensitivity to antibiotics were recorded. From this study, use of antibiotic-coated nails appears to be a valid and safe option for treatment of open tibial fractures and prevention of implant-related infections, particularly in tibial fractures with severe soft tissue exposure and impairment.

Keywords: antibiotic-coated nails; antibiotic-impregnated polymethylmethacrylate; diaphyseal infections; intramedullary nails; long-bone infection; open tibial fracture.