Infection after surgical implant generation network (SIGN) nailing in treatment of long bone shaft fractures in Ethiopia: analysis of a 4-year results

Birhanu Beza; Almaw Bitew; Debas Yaregal Melesse

doi:10.1007/s00590-022-03454-1

Infection after surgical implant generation network (SIGN) nailing in treatment of long bone shaft fractures in Ethiopia: analysis of a 4-year results

Eur J Orthop Surg Traumatol. 2023 Apr;33(3):677-684. doi: 10.1007/s00590-022-03454-1. Epub 2022 Dec 7.

Authors

Birhanu Beza¹, Almaw Bitew², Debas Yaregal Melesse³

Affiliations

¹ Department of Orthopaedic Surgery, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia.
² Department of Orthopaedic Surgery, College of Medicine and Health Sciences, University of Gondar, P. O. Box 196, Gondar, Ethiopia.
³ Department of Anaesthesia, College of Medicine and Health Sciences, University of Gondar, P. O. Box 196, Gondar, Ethiopia. dabyyaregal82@gmail.com.

Abstract

Background: One of the challenge to manage long bone fracture is the risk of infection. Intramedullary nailing is the standard treatment of long bone shaft fractures. Infection from the surgical site during orthopedic management is posing postoperative burdens in different perspectives like patient perspectives and healthcare facilities. However, there is limited information on the magnitude of infection in Ethiopia after surgical implant generation network (SIGN) nailing in the treatment of long bone shaft fractures. Therefore, the current study aimed to assess the prevalence of infection in patients with long bone shaft fractures treated with surgical implant generation network (SIGN) nailing.

Objective: To assess prevalence of infection in patients with long bone shaft fractures treated with SIGN nailing at Felege Hiwot Referral Hospital from January 1, 2015, to December 31, 2018, Bahir Dar, Northwest, Ethiopia.

Methods: This was a retrospective study over a period of 4 years. SIGN surgical-related data, presence or absence of infection from the documented information were collected from the chart/the source. The types of infection were also collected with the standard classification as superficial, deep and deep with osteomyelitis. Age, sex, fracture pattern, nature of fracture, mechanism of injury, prophylaxis antibiotics, nail type, follow-up in weeks and other factors were also extracted from the patients' charts with structured checklist. Data were analyzed with statistical package for social sciences (SPSS) version 23. The analyzed data were presented with texts, tables and a graph.

Results: Three hundred and eighty-two long bone fractures were treated by locked SIGN intramedullary nailing during the study period. After screening the inclusion criteria, a total of 311 cases were included in this study. A total of 13 (4.2%) patients who treated with SIGN intramedullary nailing developed infection.

Conclusions: We conclude that the overall prevalence of infection with SIGN intramedullary nailing is almost similar with the surgeries done in the developed countries.

Keywords: Factors; Infection; Long bone fracture; Prevalence; SIGN nail.

MeSH terms

Bone Nails / adverse effects
Ethiopia / epidemiology
Fracture Fixation, Intramedullary* / adverse effects
Fracture Fixation, Intramedullary* / methods
Fracture Healing
Fractures, Bone* / epidemiology
Fractures, Bone* / etiology
Fractures, Bone* / surgery
Humans
Postoperative Complications / etiology
Retrospective Studies
Treatment Outcome