BACTERIAL CULTURES AND OUTCOME OF INTRAMEDULLARY INTERLOCKING NAIL IN OPEN DIAPHYSEAL FRACTURES OF TIBIAL
Main Article Content
Abstract
Background: The tibial shaft is one of the most common open long bone fractures; treatment improperly can lead to many serious complications and frequently cause permanent sequelae. Infection is one of the most common and disastrous complications of an open fracture. Therefore, determining the role of qualitative bacterial cultures in implementing the most effective antibiotics for opening tibial fractures and managing promptly and with precision is extremely important to avoid these complications and restore the patient's rehabilitation. Due to the paucity of articles exclusively dealing with this topic, we conducted a study to determine bacterial cultures and the functional outcome of intramedullary interlocking nailing in these patients. Objectives: This study assessed Bacterial cultures and the outcome of intramedullary interlocking nails in open diaphyseal fractures of the tibial. Materials and Method: A cross-sectional descriptive study was conducted on 32 patients with open diaphyseal fractures of tibial who were initially treated with thorough wound debridement and lavage, followed by surgical treatment with intramedullary interlocking nails. The qualitative method of antibiotic disc diffusion in agar (Kirby Bauer) is often applied to determine the susceptibility of bacteria to different antibiotics. All 32 patients were followed up, which was conducted using clinical criteria, and a radiographic was assessed using the RUST score. Results: In our study, the injury surgery interval was 14.54±6.304 hours. Staphylococcus aureus and Staphylococcus epiderdimis were common bacteria in open tibial fractures. The mean union time was 15.43±3.726 weeks, which was assessed by RUST score and clinical criteria. The functional outcome with Ketenjian and Shelton Criteria was excellent results in 28 (87.5%) cases and good outcomes in 4 (12.5%) cases. Conclusion: Using the intramedullary interlocking nail in open diaphyseal fractures of the tibial is an excellent procedure that leads to good results with reduced hospital stay, good range of motion, and low infection rate, leading to better union.
Article Details
Keywords
open tibial fractures, bacterial cultures, intramedullary interlocking nailing, RUST score, Ketenjian and Shelton Criteria
References
2. Pollak AN, Jones AL, Castillo RC, Bosse MJ, MacKenzie EJ. The relationship between time to surgical debridement and incidence of infection after open high-energy lower extremity trauma.
J Bone Joint Surg Am. 2010. 92(1):7-15. https://doi.org/10.2106/jbjs.H.00984
3. Kuklo TR, Groth AT, Anderson RC, Frisch HM, Islinger RB. Recombinant human bone morphogenetic protein-2 for grade III open segmental tibial fractures from combat injuries in Iraq. J Bone Joint Surg Br. 2008. 90(8):1068-1072. https://doi.org/10.1302/0301620x.90b8.20349
4. Laigle M, Rony L, Pinet R, Lancigu R, Steiger V, Hubert L. Intramedullary nailing for adult open tibial shaft fracture. An 85-case series. Orthop Traumatol Surg Res. 2019. 105(5):1021-1024. https://doi.org/10.1016/j.otsr.2019.04.020
5. Islam MS, Islam SS, Parvin S, Manjur M, Islam MR, Halder RC, Islam MS, Rahaman SK, Hoque M, Faruque MO et al. Current pathogens infecting open fracture tibia and their antibiotic susceptibility at a tertiary care teaching hospital in South East Asia. Infect Prev Pract. 2022. 4(1):100205. https://doi.org/10.1016/j.infpip.2022.100205
6. Sattar SA, Farzana K, Hameed A. Resistance pattern of antibiotics against clinical isolates of Staphylococcus aureus. Pak J Pharm Sci. 2005. 18(4):18-22.
7. Alonge TO, Salawu SA, Adebisi AT, Fashina AN. The choice of antibiotic in open fractures in a teaching hospital in a developing country. Int J Clin Pract. 2002. 56(5):353-356.
8. Kamal K, Arora K, Chaudhary P, Kapilakapila R, Singh D, Mittal M. Unreamed Tibial Intramedullary Nailing (UTN) In Grade I, II And IIIA (Gustilo-Anderson) Compound Diaphyseal Fractures of Tibia-Is It Beneficial?. 2019.11-19. https://doi.org/10.9790/08531809101119
9. Theeppainthan P, Sundaram T, Anbalagan P, Pandiyan S, Rajasekaran C, Pandiyan H.
Recapitulation of primary nailing in open diaphyseal fractures of tibia. International Journal of
Research in Orthopaedics. 2019. 5. https://doi.org/10.18203/issn.24554510.IntJResOrthop20194543
10. Kumar A, Kushwaha NS, Singh S, Shantanu K, Waliullah S, Sharma V. To study outcome of intramedullary nailing in grade I and II (gustiloanderson) compound diaphyseal fractures of Tibia. International Journal of Contemporary Medical Research. 2016. 3(8):2473-2476.