Evaluation of the clinical use of the ETN PROtect in non-union therapy

• Verfasst von: Moghaddam-Alvandi, Arash [VerfasserIn]
• Verfasst von: Weis, Johanna [VerfasserIn]
• Verfasst von: Haubruck, Patrick [VerfasserIn]
• Verfasst von: Raven, Tim Friedrich [VerfasserIn]
• Verfasst von: Addali, Ayoub [VerfasserIn]
• Verfasst von: Schmidmaier, Gerhard [VerfasserIn]
• Titel: Evaluation of the clinical use of the ETN PROtect in non-union therapy
• Verf.angabe: Arash Moghaddam, Johanna Weis, Patrick Haubruck, Tim Friedrich Raven, Ayoub Addali, Gerhard Schmidmaier
• E-Jahr: 2019
• Jahr: 1 August 2019
• Umfang: 8 S.
• Illustrationen: Illustrationen
• Fussnoten: Gesehen am 02.01.2019
• Titel Quelle: Enthalten in: Injury
• Ort Quelle: Amsterdam [u.a.] : Elsevier Science, 1969
• Jahr Quelle: 2019
• Band/Heft Quelle: 50(2019), Seite 32-39
• ISSN Quelle: 1879-0267
• DOI: doi:10.1016/j.injury.2019.07.009
• Datenträger: Online-Ressource
• Sprache: eng
• Sach-SW: Antibiotic coating
• Sach-SW: Gentamicin
• Sach-SW: Infection
• Sach-SW: Intramedullary nailing
• Sach-SW: Non-union
• Sach-SW: Tibia
• K10plus-PPN: 1686375336

Abstract

Introduction - Non-union of a long bone fracture remains a challenge in orthopaedic and trauma surgery. In the current study, we sought to determine the clinical effectiveness of tibial non-union treatment utilizing an antibiotic-coated intramedullary nail (Expert Tibia Nail (ETN) PROtect®) regarding prevention and treatment of infection and the clinical outcome. - Patients and methods - 36 patients suffering from tibial non-unions that were treated with the ETN PROtect® in the course of non-union treatment between February 2010 and March 2015 were included in this clinical observational study. Clinical and radiological examinations were performed preoperatively as well as 4, 6 and 12 weeks and 6 and 12 months postoperatively as part of a standardized follow-up program. Data regarding perioperative complications, weight-bearing capacity, radiological signs of consolidation and subjective health status were assessed at each time point. Laboratory parameters such as C-reactive protein (CRP) and leukocyte count were collected preoperatively in order to assess the patients’ risk profile for infection. - Results - Patients had an average of 6.2 previous surgeries and 22 patients (61.1%) had a positive bacterial culture from intraoperatively removed tissue during the first operative treatment. 29 patients (80.6%) achieved full weight-bearing after an average of 7.7 months, furthermore 80.6% of patients achieved osseous consolidation. 3 deep infections occurred, including one amputation. Subjective health status increase based on the SF-12 questionnaire during our follow-up program. - Conclusion - The results from the current study indicate that the use of the ETN PROtect® in the applied non-union therapy has a high clinical effectiveness regarding osseous consolidation and time to weight bearing. In addition, the use of gentamicin-coated nails in the treatment of tibial non-unions might contribute to both successful treatment of the underlying infection and prevention of perioperative infection. The gentamicin-coated nail may serve as a beneficial adjunct treatment in the applied non-union therapy in addition to all established techniques in the treatment of infected non-unions.