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The Infected Tibial Nail

  • Megan A. Brady
  • Seth A. Cooper
  • Brendan M. Patterson
Chapter

Abstract

This chapter focuses on the clinical presentation, diagnosis, treatment options, and long-term prognosis of infected tibial nails utilizing both retrospective and prospective data ranging from 1975 to 2017.

Keywords

Antibiotics Timing of debridement Hardware removal versus retention Outcomes of treatment Infected tibial intramedullary nail 

References

  1. 1.
    Melvin J, Dombroski D, et al. Open tibial shaft fractures: evaluation and initial wound management. J Am Acad Orthop Surg. 2010;18:10–9.CrossRefGoogle Scholar
  2. 2.
    Gustilo R, Anderson J. Prevention of infection in the treatment of one thousand and twenty-five open fractures of long bones. J Bone Joint Surg. 1976;58:453–8.CrossRefGoogle Scholar
  3. 3.
    Brumback R, Jones A. Interobserver agreement in the classification of open fractures of the tibia. The results of a survey of two hundred and forty-five orthopaedic surgeons. J Bone Joint Surg. 1994;76:1162–6.CrossRefGoogle Scholar
  4. 4.
    Aderinto J, Keating J. Intramedullary nailing of fractures of the tibia in diabetics. J Bone Joint Surg Br. 2008;90:638–42.CrossRefGoogle Scholar
  5. 5.
    Harrison WJ, et al. Open fracture of the tibia in HIV positive patients: a prospective controlled single-blind study. Injury. 2004;35:852–6.CrossRefGoogle Scholar
  6. 6.
    Harvey ER, et al. Deleterious effect of smoking on healing of open tibia shaft fractures. Am J Orthop. 2002;31:518–21.PubMedGoogle Scholar
  7. 7.
    Patzakis M, et al. The role of antibiotics in the management of open fractures. J Bone Joint Surg. 1974;56:532–41.CrossRefGoogle Scholar
  8. 8.
    Tornetta P, et al. Treatment of grade-IIIb open tibial fractures: a prospective randomized comparison of external fixation and non-reamed locked nailing. J Bone Joint Surg. 1994;76Br:13–9.CrossRefGoogle Scholar
  9. 9.
    Patzakis M, Zalavras C. Chronic posttraumatic osteomyelitis and infected nonunion of the tibia: current management concepts. J Am Acad Orthop Surg. 2005;13(6):417–27.CrossRefGoogle Scholar
  10. 10.
    Dellinger EP, et al. Duration of preventive antibiotic administration for open extremity fractures. Arch Surg. 1988;123:333–9.CrossRefGoogle Scholar
  11. 11.
    Kakar S, Tornetta P. Open fractures of the tibia treated by immediate intramedullary tibial nail insertion without reaming: a prospective study. J Orthop Trauma. 2007;21:153–7.CrossRefGoogle Scholar
  12. 12.
    Thonse R, et al. Antibiotic cement-coated interlocking nail for the treatment of infected nonunions and segmental bone defects. J Orthop Trauma. 2007;21:258–68.CrossRefGoogle Scholar
  13. 13.
    Calhoun J, et al. The treatment of infected nonunions with gentamicin-polymethylmethacrylate antibiotic beads. Clin Orthop. 1993;295:23–7.Google Scholar
  14. 14.
    Merritt K, Dowd J. Role of internal fixation in infection of open fractures: studies with Staphylococcus Aureus and Proteus Mirabilis. J Orthop Res. 1987;5(1):23–8.CrossRefGoogle Scholar
  15. 15.
    Berkes M, et al. Maintenance of hardware after early postoperative infection following fracture internal fixation. J Bone Joint Surg. 2010;92:823–8.CrossRefGoogle Scholar
  16. 16.
    Dunbar R. Treatment of infection after fracture fixation. J Orthop Trauma. 2007;21(7):503–5.CrossRefGoogle Scholar
  17. 17.
    Gristina A, Costerton J. Bacterial adherence to biomaterials and tissue. The significance of its role in clinical sepsis. J Bone Joint Surg. 1985;67:264–73.CrossRefGoogle Scholar
  18. 18.
    Paley D, Maar D. Ilizarov bone transport treatment for tibial defects. J Orthop Trauma. 2000;14:76–85.CrossRefGoogle Scholar
  19. 19.
    Struijs P, et al. Infected nonunion of the long bones. J Orthop Trauma. 2007;21(7):507–11.CrossRefGoogle Scholar
  20. 20.
    Rozbruch R, et al. Repair of tibial nonunions and bone defects with the Taylor spatial frame. J Orthop Trauma. 2008;22(2):88–95.CrossRefGoogle Scholar
  21. 21.
    Theis J, et al. Correction of complex lower limb deformities by the Ilizarov technique: an audit of complications. J Orthop Sug. 2000;8(1):67–71.CrossRefGoogle Scholar
  22. 22.
    Paley D, Herzenberg J. Intramedullary infections treated with antibiotic cement rods: preliminary results in nine cases. J Orthop Trauma. 2002;16(10):723–9.CrossRefGoogle Scholar
  23. 23.
    Court-Brown CM, et al. Infection after intramedullary nailing of the tibia: incidence and protocol for management. J Bone Joint Surg Br. 1992;74B:770–4.CrossRefGoogle Scholar
  24. 24.
    Metsemakers WJ, Reul M, Nijs S. The use of gentamicin-coated nails in complex open tibia fracture and revision cases: a retrospective analysis of a single centre case series and review of the literature. Injury. 2015;46(12):2433–7.CrossRefGoogle Scholar
  25. 25.
    Leduc S, Ricci W. Two-stage protocol: treatment of nonunion after treatment of infection. J Orthop Trauma. 2007;21(7):505–6.CrossRefGoogle Scholar

Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  • Megan A. Brady
    • 1
  • Seth A. Cooper
    • 2
  • Brendan M. Patterson
    • 3
  1. 1.Iowa Methodist Medical Center, Des Moines Orthopedic SurgeonsWest Des MoinesUSA
  2. 2.Department of Orthopaedic SurgeryFlorida Medical ClinicTampaUSA
  3. 3.Department of Orthopedic SurgeryCleveland Clinic Main Campus, Case Western Reserve University School of MedicineClevelandUSA

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