Evidence map›Paper›PMID 35943591›Full record

ArticleEuropean journal of orthopaedic surgery & traumatology : orthopedie traumatologie2023

A major trauma centre experience with gentamicin-coated tibial intramedullary nails (ETN PROtect™) in acute primary open fracture fixation and complex revision surgery.

Kavi H Patel, Athanasios Galanis, Prabu Balasubramanian, Alexios D Iliadis, Nima Heidari, Alex Vris

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Article in European journal of orthopaedic surgery & traumatology : orthopedie traumatologie, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.

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6citing papers in PubMed
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1 · What the graph read from it

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3 · Its place in the literature

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6 citing papers in PubMed.

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4 · The record

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5 · Who and what money

Authors and funding

6 authors.

Kavi H PatelLimb Reconstruction and Bone Infection Service, The Royal London Hospital, Barts Health NHS Trust, Whitechapel Road, London, E1 1FR, UK. kavi.patel@nhs.net.ORCID http://orcid.org/0000-0002-5154-9357
Athanasios GalanisKAT General Hospital, Nikis 2, 145 61, Kifisia, Greece.
Prabu BalasubramanianLimb Reconstruction and Bone Infection Service, The Royal London Hospital, Barts Health NHS Trust, Whitechapel Road, London, E1 1FR, UK.
Alexios D IliadisLimb Reconstruction and Bone Infection Service, The Royal London Hospital, Barts Health NHS Trust, Whitechapel Road, London, E1 1FR, UK.
Nima HeidariLimb Reconstruction and Bone Infection Service, The Royal London Hospital, Barts Health NHS Trust, Whitechapel Road, London, E1 1FR, UK.
Alex VrisLimb Reconstruction and Bone Infection Service, The Royal London Hospital, Barts Health NHS Trust, Whitechapel Road, London, E1 1FR, UK.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeFracture-related infections (FRI) following intramedullary nailing for tibial shaft fractures remain challenging to treat with associated high patient morbidity and health care costs. Recently, antibiotic-coated nails have been introduced as a strategy to reduce implant related infection rates in high-risk patients. We present the largest single-centre case series on ETN PROtect® outcomes reporting on fracture union, infection rates and treatment complications.

methodsFifty-six adult patients underwent surgery with ETN PROtect® between 01/09/17 and 31/12/20. Indications consisted of acute open fractures and complex revision cases (previous FRI, non-union surgery and re-fracture) with a mean of three prior surgical interventions. We report on patient demographics, union rates and deep infection. Minimum follow-up was one year.

resultsOne (1.8%) patient developed a deep surgical infection and associated non-union requiring further surgery. In addition, we identified three cases (5.4%) of aseptic non-union following facture treatment with ETN PROtect®. Of the five patients who underwent staged complex revision surgery for established FRI with ETN PROtect®, all had treatment failure with ongoing symptoms of deep infection requiring implant removal and further treatment.

conclusionUse of the ETN PROtect® nail in high-risk patients (open fractures and those initially treated with external fixation) and in those patients with aseptic non-unions, demonstrates promising outcomes in the prevention of implant-related infection. In our limited series we have failed to observe any benefit over uncoated nails, when used in treating cases of previously established FRI/osteomyelitis and would therefore advise caution in their use, especially in view of the high cost.

Indexed as

Fracture Fixation, IntramedullaryFractures, OpenTibial FracturesAdultBone NailsFracture HealingGentamicinsHumansPostoperative ComplicationsReoperationTrauma CentersTreatment OutcomeGentamicinsAntibiotic coatingBone infectionIntramedullary nailingOpen fracturesTibia

Identifiers

PMID35943591

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.