Infections in primary intramedullary nailing of open tibial fractures: a review article

M. Lillo, O. El Ezzo, M. Cauteruccio, A. Ziranu, V. De Santis, G. Maccauro

Department of Orthopaedics, Fondazione Policlinico Agostino Gemelli – IRCCS, Università Cattolica del Sacro Cuore di Roma, Rome, Italy. marcolillo.01@gmail.com

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• Infectious Diseases
• Orthopedics

OBJECTIVE: Open fractures are insidious and life-threatening injuries. They frequently involve the leg. Our aim is to evaluate the efficacy of primary intramedullary nailing as a definitive treatment of open tibial fractures, compared to other fixation tools in terms of deep infections, healing fracture time and bony repair.
PATIENTS AND METHODS: We reviewed the available literature concerning treatment and management of open tibial fractures.
RESULTS: Primary intramedullary nailing is similar to delayed intramedullary nailing after external fixation in terms of union, malunion and nonunion rate.
Furthermore, primary intramedullary nailing is superior compared to all other fixation tools, in terms of development of deep infections, provided that a good debridement of soft tissue, lavage of the fracture site and adequate antibiotic prophylaxis should be performed before nailing.
CONCLUSIONS: Primary intramedullary nailing should be considered for the definitive treatment of open tibial fractures, providing many advantages in terms of rehabilitation, time of hospitalization and costs.

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