Gentamicin-coated Tibial nail is Effective in the treatment
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Implant-associated infections are a major problem in orthopedics and trauma surgery, posing a significant burden on patients and health-care services and necessitating significant improvements in infection prevention and clinical outcomes.

One strategy includes the usage of antimicrobial-coated implants. Researchers evaluated outcomes after surgical treatment using a gentamicin-coated nail on -
(i) Treatment success in terms of bone consolidation,
(ii) Absence of infection, and
(iii) Patient-reported quality of life in a patient cohort with high risk of infection/reinfection and treatment failure.

A retrospective study of 13 patients treated with a gentamicin-coated intramedullary nail (ETN ProtectTM) for open tibia fractures (n = 4), non-unions (n = 2), and fracture-related infection (n = 7) was conducted. The EQ-5D, SF-36, and an ICD-10-based symptom rating were used to assess quality of life (ISR).

Results:
--At a mean follow-up of 2.8 years, 11 of the 13 patients (84.6%) achieved bone consolidation without any additional surgical intervention, whereas two patients required a revision surgery due to infection and removal of the implant. No specific implant-related side effects were noted.

--Quality of life scores were significantly lower compared to a German age-matched reference population.

--The mean ISR scores revealed mild psychological symptom burden on the scale depression.

To summarize, the use of a gentamicin-coated intramedullary nail to prevent infection complications and achieve bony union appears to be appropriate in open fractures and revision surgery for aseptic non-union or known fracture-related infection. Despite the effectiveness of the gentamicin-treated implant in treating difficult cases, the dramatically decreased quality of life experienced following treatment highlights the need for additional measures to enhance surgical treatment methods and psychological support.

Source: https://josr-online.biomedcentral.com/articles/10.1186/s13018-021-02411-8
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