Evidence map›Paper›PMID 39870821›Full record

ArticleEuropean journal of trauma and emergency surgery : official publication of the European Trauma Society2025

Does a gentamicin-coated intramedullary nail prevent postoperative infection in Gustilo type I and II tibial open fractures? A comparative study and retrospective analysis.

S K Rai, T P Gupta, Manoj Kashid, Bhavya Sirohi, Amit Kale, Ritesh Sharma, Arjun Gandotra

Abstract readComparative Study
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In one paragraph

Article in European journal of trauma and emergency surgery : official publication of the European Trauma Society, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

5 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Antibiofilm-coated intramedullary nailing for tibial and femoral diaphyseal fractures at high-risk infection: outcomes of 103 consecutive patients.Journal of orthopaedics and traumatology : official journal of the Italian Society of Orthopaedics and Traumatology · 2026
    Observational
  3. Review
  4. Current developments in orthopaedic implant technology.Journal of orthopaedic surgery and research · 2025
    Review
  5. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

S K RaiMilitary Hospital Ambala Cantt, Ambala, Haryana, 133001, India. skrai47@yahoo.com.
T P GuptaBase Hospital, Delhi Cantt, New Delhi, 110010, India.
Manoj KashidSMBT Medical Collage Igatpuri, Nashik, Maharashtra, 422402, India.
Bhavya SirohiMilitary Hospital, Agra, UP, 282001, India.
Amit KaleMilitary Hospital, Jammu, 180003, India.
Ritesh SharmaBase Hospital, Delhi Cantt, New Delhi, 110010, India.
Arjun GandotraDr C Lal Hospital, Ambala Cantt, Haryana, 133001, India.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeTibial open shaft fractures are very common and susceptible to infection, which can lead to significant morbidity especially infection and non-union. Antibiotic coated nail is one option for fixing open shaft tibial fractures to minimise infection. This study aimed to compare the clinical outcome of Gentamicin-coated tibial nails versus regular unreamed interlocking tibial nails in the treatment of type I and II tibial open fractures.

methodsBetween 2013 and 2020, in a retrospective study of 124 patients with Gustilo type I and II tibial fractures compared non-antibiotic-coated nails (62 patients) with gentamicin-coated nails (62 patients) over 12 months. This study assessed infection rates, duration of hospital stays, fracture union time, and complications.

resultsThe antibiotic nail group had significantly lower postoperative infection rates (3.2%) than the regular nail group (17.7%), (χ2 = 4.64, p = 0.031). At the 6-month follow-up, significant differences were observed in ESR (p = 0.031), CRP (p = 0.019), leukocyte count (p = 0.0241), and blood culture (p = 0.018), but not in hemoglobin levels (p = 0.067). The Gentamicin-coated nail group demonstrated better fracture union rates at 6 and 12 months, (p = 0.0267) and lower overall complication rates.

conclusionA tibial nail coated with Gentamicin is an effective method for preventing infection in type I and II open fracture shafts of the tibia. It allows, shortens hospital stay and healing time, prevents infection, and thus reduces the chance of a second surgery. LEVEL OF EVIDENCE: Level III, a retrospective study.

designRetrospective analytical study. HYPOTHESIS: We hypothesized that Gentamicin-coated nail is effective in preventing infection in Gustilo type I and II open fractures compared to non-antibiotic-coated regular nails.

Indexed as

Anti-Bacterial AgentsBone NailsFracture Fixation, IntramedullaryFractures, OpenGentamicinsSurgical Wound InfectionTibial FracturesAdultAgedFemaleHumansLength of StayMaleMiddle AgedRetrospective StudiesAnti-Bacterial AgentsGentamicinsGentamicin-coated nailInfectionIntramedullary nailingOpen tibia fracture

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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.