Evaluation of the clinical use of the ETN PROtect in non-union therapy
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®) regardin...
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| Hauptverfasser: | , , , , , |
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| Dokumenttyp: | Article (Journal) |
| Sprache: | Englisch |
| Veröffentlicht: |
1 August 2019
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| In: |
Injury
Year: 2019, Jahrgang: 50, Pages: 32-39 |
| ISSN: | 1879-0267 |
| DOI: | 10.1016/j.injury.2019.07.009 |
| Online-Zugang: | Verlag, Volltext: https://doi.org/10.1016/j.injury.2019.07.009 Verlag, Volltext: http://www.sciencedirect.com/science/article/pii/S0020138319304085 
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| Verfasserangaben: | Arash Moghaddam, Johanna Weis, Patrick Haubruck, Tim Friedrich Raven, Ayoub Addali, Gerhard Schmidmaier |
| Zusammenfassung: | 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. |
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| Beschreibung: | Gesehen am 02.01.2019 |
| Beschreibung: | Online Resource |
| ISSN: | 1879-0267 |
| DOI: | 10.1016/j.injury.2019.07.009 |