Lower Infection Rate after Interlocking Nailing in Open Fractures of Femur and Tibia

Kaltenecker, G.; Wruhs, O; Quaicoe, Sannichie

doi:10.1097/00005373-199030040-00019

Cited by 44 publications

(19 citation statements)

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“…We identified four studies of the use of reamed intramedullary nails in the management of open tibial fractures. 37,55,60,61 Two were retrospective cohort studies, 60,61 one was a prospective study 37 and the other was a randomised, prospective clinical trial. 55 They described 187 fractures of which 43% were grade-III open injuries (IIIA, 16%; IIIB, 27%).…”

Section: Skeletal Injurymentioning

confidence: 99%

“…Hence, the management of these serious injuries should follow the guidelines of the Advanced Trauma Life Support System 12 and the principles of 'damage control orthopaedics'. 61 Although intramedullary nailing is currently considered to be the optimum method of treating closed femoral fractures, less consensus has been reached as to the best means of stabilisation of open fractures. Various methods of fixation have been used in the treatment of open femoral fractures.…”

Section: Open Fractures Of the Femoral Shaftmentioning

confidence: 99%

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A review of the management of open fractures of the tibia and femur

Giannoudis

Papakostidis

Roberts

2006

The Journal of Bone and Joint Surgery. British volume

229

153

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Section: Skeletal Injurymentioning

confidence: 99%

Section: Open Fractures Of the Femoral Shaftmentioning

confidence: 99%

A review of the management of open fractures of the tibia and femur

Giannoudis

Papakostidis

Roberts

2006

The Journal of Bone and Joint Surgery. British volume

229

153

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“…5 Bone and Johnson reported only 2 infection after treatment of grade II & grade III with nailing after reaming. 13 Kaltenecker et al reported no infections after treatment of sixty-six type-I and II open tibial fractures with nailing after reaming. 14,15 Our study shows similar results compared to these recent studies.…”

Section: Discussionmentioning

confidence: 97%

“…Early reports of the use of nails with reaming for open tibial fractures seemed to confirm this view. 13 Smith found a rate of infection of 33% in series of 18 open tibial fractures treated with intramedullary nailing with reaming, most of fracture associated with sever soft tissue injury. 9 But with recent advances in surgical techniques and advanced wound care techniques, Some traumatologists believe that intramedullary nailing with reaming may be used safety for fractures with less severe wounds.…”

Section: Discussionmentioning

confidence: 99%

A Comparative Study of Reamed and Unreamed Intramedullary Interlocking Nailing in Compound Fractures of Shaft of Tibia

Gunaki¹,

Mane²,

Kulkarni³

et al. 2015

jebmh

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Whether to ream the compound tibia fractures witle intramedullary interlocking nailing or not has been an eternal debate. So we have conducted a study to compare the functional outcomes, rate of infection and time needed for union in reamed and unreamed interlocking nailing on open tibia fractures. METHODOLOGY: This study was carried out as a prospective, comparative study. 100 patients with open fractures of tibial shaft admitted in our hospital between June 2011 and January 2013 were enrolled in the study. Patients outside the age group of 20-50years of age, severely ommuniated fractures and fractures classified under Gustilo Anderson type IIIb and IIIc were excluded. 100 fractures were divided into two groups (reamed nailing and unreamed nailing) n=50 in each with simple randomization technique. Evaluation in the form of radiological union was done with serial x-rays and functional grading according to Klemm & Borner's criteria for tibial shaft fractures was done at the end of 6 months. RESULTS: Average fracture healing time was 16-20 weeks in both in undreamed nailing radiologically. Also, differences in rates of clinical union, clinical outcome, time for weight bearing and complication in both groups were not significant. Post-operative infection was found in 5 cases in reamed group and 3 cases in unreamed group. CONCLUSION: There are no clear indications or contraindications or advantage/disadvantage to favour either reamed or unreamed nailing over each other. Fracture union, functional outcome and rate of complications are similar in both groups. KEYWORDS: Reamed versus unreamed intramedullary interlocking nailing; fractures of shaft of tibia.

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“…Intramedullary interlocking nail (IIN) fixation of these fractures is an attractive treatment alternative because it has the potential to provide a biological and mechanical environment that can optimize fracture healing 7–12 . Insertion of the nail from a site distant to the fracture may decrease the likelihood of infection and delayed union by minimizing soft tissue and vascular disruption at the fracture site 13–15 . MC3 fractures in adult horses are often comminuted with palmar fragmentation.…”

mentioning

confidence: 99%