A Definitive Role of Antibiotic Impregnated Nailing in Compound Fractures of Tibia | Chapter 11 | Medical Research and Its Applications Vol. 9

 

Introduction: Antibiotic nails are currently the preferred treatment for Gustilo Type I, II, and IIIA fractures, replacing the conventional approach of fixing open tibia fractures. They not only expedite the one-step bone union process but also lessen the systemic adverse effects of parenteral antibiotics after surgery. These nails elute the antibiotic exactly in the right doses where it is needed to combat the infection and prevent a possible delayed union or hostile environment in Gustilo type I, II and IIIA compound tibial fractures.

 

Aim: The aim was to determine the definitive role of antibiotic-impregnated Intramedullary (IM) nailing in compound tibial fractures.

 

Materials and Methods: We treated twenty-five adults having compound tibial shaft fractures of Gustilo Type I and Type II and IIIA with antibiotic-impregnated IM nails to evaluate the outcome.

 

Results: Results were excellent to good in 92% (Lysholm’s scale). Partial weight bearing commenced at 5.44 weeks and full weight bearing after 10.48 weeks of operation on average. Radiological union achieved in 12 to 18 weeks (average 15.55 weeks) in all AO (Arbeitsgemeinschaft für Osteosynthesefragen, German for “Association for the Study of Internal Fixation”) group A, group B fractures with Gustilo type I injury. Complex (AO group C), while Gustilo type II took 12 to 22 weeks (average 16.69 weeks). One Gustilo type IIIA fracture showed delayed union (beyond 22 weeks). There was minimal incidence of infection [overall 24% (20% in type II- superficial in 12% and deep in 8% cases; 4% in type IIIA-deep)]. One Gustilo type IIIA fracture showed infection along the deeper tissue planes. In the present study, results were better when compared with the above-quoted studies as 100% union was achieved with an overall infection rate of 24% only. The infection did not hinder the union and resolved with a local antibiotic release through nail and concurrent administration of systemic antibiotics.

 

Conclusion: Antibiotic-impregnated nails can be a trustworthy alternative single-stage treatment modality, obviating the need for multiple procedures to achieve the bony union in open fractures of the tibia. Early range of motion exercises of joints and early weight bearing are permitted because breakage of the implant is very uncommon due to load sharing.

 

 

Author(s) Details

Kamal Kumar Arora
Government Medical College, Amritsar, Punjab, India.

 

Please see the book here:- https://doi.org/10.9734/bpi/mria/v9/1136

An Epidemiological Profile and Management of Floating Knee at the Traumatology and Orthopedics Department (Section A) of Hassan II Hospital, Fez/Morocco | Chapter 3 | Current Innovations in Disease and Health Research Vol. 1

 Present study climaxes the epidemiological profile and administration of floating knee at the traumatology and Orthopedics area (section A) of Hassan II Hospital, Fez/Morocco. The buoyant knee is an union of ipsilateral femur and tibia fractures first expressed by BLAKE and MCBRYDE in 1974. The study retrospectively reviewed the cases of 32 inmates who were conducted between January 2009 and November 2018. We only included subjects with a buoyant knee. Staging and indexing two together used Frazer's classification. Open fractures were judged preoperatively for severity of accompanying injuries utilizing the Injury Severity Score and the Cauchoix-Duparc classification. Functional outcomes were determined use the Karlstrom and Olerud criteria. Young alive adults were ultimate affected accompanying a mean age of 28 years and a clear male predominance (90.62%). Road accidents were the main cause (93.75%).According to Fraser's categorization, 68.75% of cases were type I, type IIa (15.62 %), type IIb (9.37%) and type IIc (6.25%). Seventeen patients met with IM nailing of both leg part and tibia fractures. Four patients (12.5%) seen ORIF with DCP leg part plate; 3 patients (9.37%) experienced condylar plate bridging of the femur; inasmuch as 2 patients (6.25%) withstood ORIF of tibia accompanying DCP plate and 2 patients (6.25%) with T-buttress plate of the tibial land. The advent of various modes of transport accompanying the growth of the automobile manufacturing and especially the disobedience with the highway safety regulations are chiefly to blame for the surge attack traffic accidents. In Morocco, RTA’s are the main etiology of buoyant knees.The floating knee is a condition namely slowly extended over our side of the world and generally affects young, active family. Most typically, transmission-clinical disease is used. A skilled integrative team bear carry out administration because it is operational.

Author(s) Details:

Kamal Lahrach,
Department of Trauma and Orthopedics A, Hassan II Hospital, University Sidi Mohammed Ben Abdellah of Fez, Morocco.

Boubacar Soumaré,
Department of Trauma and Orthopedics A, Hassan II Hospital, University Sidi Mohammed Ben Abdellah of Fez, Morocco.

Saeed Abdul Razak,
Department of Trauma and Orthopedics A, Hassan II Hospital, University Sidi Mohammed Ben Abdellah of Fez, Morocco.

Bah Souleymane,
Department of Trauma and Orthopedics A, Hassan II Hospital, University Sidi Mohammed Ben Abdellah of Fez, Morocco.

Diarra Abdoul Salam,
Reference Health Center of Mopti,Mali.

Boutayeb Fawzi,
Department of Trauma and Orthopedics A, Hassan II Hospital, University Sidi Mohammed Ben Abdellah of Fez, Morocco.

Please see the link here: https://stm.bookpi.org/CIDHR-V1/article/view/11059

Critical Overview on Missed Clavicular Fracture in an Adult without Head Injury or Polytrauma Review of Literature and a Rare Case | Chapter 6 | Research Trends and Challenges in Medical Science Vol. 2

We present a case of missed clavicular fracture in a patient with an associated wrist fracture but without head injury. This is the first case of missed clavicular fracture in an adult, despite adequate imaging, and without head injury presenting two days after the patient was discharged after fixation of the distal radius fracture.
  

Author(s) Details

Dr. A. Raviraj
Department of Orthopedic Surgery, Apollo Hospitals, Bannerghatta Road, Bangalore-560076, India.

Ashish Anand
Department of Orthopedics, University of Mississippi Medical Center, Jackson, VAMC Jackson, Mississippi, USA.

View Book :- http://bp.bookpi.org/index.php/bpi/catalog/book/190