Cigarette smoking influences the clinical and occupational outcome of patients with tibial shaft fractures

Moghaddam-Alvandi, Arash; Zimmermann, G.; Hammer, Kathrin; Brückner, Thomas; Grützner, Paul Alfred; Recum, Jan von

doi:10.1016/j.injury.2012.08.017

Cited by 15 publications

(19 citation statements)

References 3 publications

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“… 3 – 6 Especially, open fractures after high energy trauma are at risk of infections. 7 – 10 Depending on the severity of the fracture, infection rates range from 6% to 33%. 1 , 10 , 11 Noteworthy is that up to 80% of all deep infections developed in Gustilo grade III open fractures.…”

Section: Introductionmentioning

confidence: 99%

“…For the treatment of extra-articular tibial defects, intramedullary nailing is currently the gold standard. 10 , 22 SYNTHES (SYNTHES AG GmbH, DePuy Synthes Companies, Zuchwil, Switzerland) special antibiotic-coated nails were introduced in 2005 as a universal intramedullary implant for tibial fractures. Up to 2011, over 100 patients were treated with unreamerd tibia Nail (UTN) PROtect or Expert Tibia Nail (ETN) PROtect™.…”

Section: Introductionmentioning

confidence: 99%

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Patients’ safety: is there a systemic release of gentamicin by gentamicin-coated tibia nails in clinical use?

Moghaddam

Graeser

Westhauser

et al. 2016

TCRM

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IntroductionOsteitis is one of the most serious complications in orthopedic surgery. Expert Tibia Nail (ETN) PROtect™ coated with a biodegradable layer of gentamicin-laden polymer was developed for prophylaxis of osteomyelitis. In systemic administration, gentamicin has only a small therapeutic index and serious side effects; it is potentially nephrotoxic as well as ototoxic. It is not yet known if relevant gentamicin concentrations are released into the systemic circulation after implantation of gentamicin-coated nails. In order to evaluate the patients’ risks profiles and increase patient safety, we measured gentamicin levels in pre- and postoperative serum samples of patients undergoing implantation of ETN PROtect.MethodsTwenty-five patients who received ETN PROtect between March 2012 and August 2014 were included in this study. Collection of blood samples occurred before the operation, at weeks 1–4, 3 and 6 months, and up to 1 year after the implantation. Measurement of gentamicin levels in serum samples was performed at the central laboratory of Heidelberg University Hospital. Additionally, laboratory parameters, C-reactive protein, leukocyte number, urea and creatinine concentrations were analyzed in routine controls before and after operating and assessed for systemic side effects.ResultsOver the course of this prospective observational study, we were able to determine that gentamicin-coated nails do not release gentamicin into the systemic circulation above the lowest detectable level of 0.2 mg/dL. There were slight increases in the mean inflammation and renal retention markers, but no gentamicin-associated side effects could be linked to implantation. Furthermore, no allergic reactions could be detected during our study.ConclusionOur findings suggest that there is no relevant release of gentamicin into the systemic circulation causing a systemic effect, and serious side effects due to gentamicin-coated tibia nails should not be feared. Postoperative monitoring of renal function does not seem necessary because of the implantation of ETN PROtect.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Patients’ safety: is there a systemic release of gentamicin by gentamicin-coated tibia nails in clinical use?

Moghaddam

Graeser

Westhauser

et al. 2016

TCRM

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“…Studies were scored independently by AN and BT based on the criteria listed in Appendix I. The risk factors for delayed bony healing included in the methodological score were in accordance with those identified in the current literature …”

Section: Methodsmentioning

confidence: 99%

Delayed/non‐union of upper limb fractures with bisphosphonates: systematic review and recommendations

Yue

Joseph

et al. 2014

ANZ Journal of Surgery

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“…In the United States, approximately 100,000 fractures result in nonunion each year . Fractures which progress to nonunion are difficult to treat, with many leading to marked disability from pain or functional impairment . In addition to individual patient disability, nonunion is associated with increased healthcare utilization and cost …”

Section: Introductionmentioning

confidence: 99%

Genomewide Association Study of Fracture Nonunion Using Electronic Health Records

et al. 2018

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Nonunion is a clinically significant complication of fracture associated with worse outcomes, including increased pain, disability, and higher healthcare costs. The risk for nonunion is likely to be complex and multifactorial, and as such, the biology underlying such risk remains poorly understood. Genetic studies represent one approach to identify implicated biology for further investigation, but to date the lack of large cohorts for study has limited such efforts. We utilized the electronic health records of two large academic medical centers in Boston to identify individuals with fracture nonunion and control individuals with fracture but no evidence of nonunion. We conducted a genomewide association study among 1760 individuals of Northern European ancestry with upper or lower extremity fracture, including 131 with nonunion, to examine whether common variants were associated with nonunion in this cohort. In all, one locus in the Calcyon (CALY) gene exceeded a genomewide threshold for statistical significance (p = 1.95e–8), with eight additional loci associated with p < 5e–7. Previously reported candidate genes were not supported by this analysis. Electronic health records should facilitate identification of common genetic variations associated with adverse orthopedic outcomes. The loci we identified in this small cohort require replication and further study to characterize mechanism of action, but represent a starting point for the investigation of genetic liability for this costly outcome. © 2018 American Society for Bone and Mineral Research.

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Cigarette smoking influences the clinical and occupational outcome of patients with tibial shaft fractures

Cited by 15 publications

References 3 publications

Patients’ safety: is there a systemic release of gentamicin by gentamicin-coated tibia nails in clinical use?

Patients’ safety: is there a systemic release of gentamicin by gentamicin-coated tibia nails in clinical use?

Delayed/non‐union of upper limb fractures with bisphosphonates: systematic review and recommendations

Genomewide Association Study of Fracture Nonunion Using Electronic Health Records

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Cigarette smoking influences the clinical and occupational outcome of patients with tibial shaft fractures

Cited by 15 publications

References 3 publications

Patients&rsquo; safety: is there a systemic release of gentamicin by gentamicin-coated tibia nails in clinical use?

Patients&rsquo; safety: is there a systemic release of gentamicin by gentamicin-coated tibia nails in clinical use?

Delayed/non‐union of upper limb fractures with bisphosphonates: systematic review and recommendations

Genomewide Association Study of Fracture Nonunion Using Electronic Health Records

Contact Info

Product

Resources

About

Patients’ safety: is there a systemic release of gentamicin by gentamicin-coated tibia nails in clinical use?

Patients’ safety: is there a systemic release of gentamicin by gentamicin-coated tibia nails in clinical use?