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

Abstract Purpose Tibial 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. Methods In the present study of 124 patients with Gustilo type I and II tibial fractures, 62 patients were treated with non-antibiotic-coated regular nails (control group, Group A), and 62 patients were treated with Gentamicin-coated nails (study group, Group B). They were followed for 12 months for fracture union. Fracture union was assessed by The Radiographic Union Scale for Tibial fractures (RUST) criteria. Results The postoperative infection rate in the regular nail group was 9.6% (6/62 patients), whereas it was 3.2% (2/62 patients) in the antibiotic nail group (χ2 = 4.64\chi^2 = 4.64χ2 = 4.64, p = 0.031p = 0.031p = 0.031). The Gentamicin-coated nail group showed a better fracture union rate compared to the regular nail group at the 6-month and 12-month follow-ups (p = 0.0267p = 0.0267p = 0.0267). Conclusion A 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 prospective study