A comparative study of clinical and radiological outcomes of open tibia fractures, managed with uncoated versus antibiotic coated intramedullary interlocking nail

Background: Open tibia fractures are a significant clinical challenge, especially in densely populated regions like Jaipur, Rajasthan, where elevated trauma incidence and diverse healthcare access issues compound treatment intricacies. This study compares the clinical and radiological outcomes of open tibia fractures managed with conventional uncoated intramedullary nails versus antibiotic-coated intramedullary interlocking nails. The introduction of antibiotic-coated nails aims to reduce the incidence of infection, a major concern in open fractures due to the direct exposure of the fracture site to the external environment. Methods: A prospective, observational study was conducted at the department of orthopedics, SMS Hospital, Jaipur, focusing on a cohort of 100 patients with open tibia fractures treated from January 2016 to December 2018. Patients were included based on specific criteria, including the type of fracture and the treatment received, either with uncoated or antibiotic-coated intramedullary nails. Data were collected retrospectively from hospital and operation charts, with radiographs and clinical information reviewed independently by two authors. Results: The comparison revealed a lower infection rate and a higher rate of bone union at 12 months in the group treated with antibiotic-coated nails versus the uncoated group. Specifically, the antibiotic-coated group showed a 10% lower infection rate and a 10% higher bone union rate. Conclusions: The use of antibiotic-coated intramedullary nails for the treatment of open tibia fractures demonstrates a promising reduction in infection rates and improved bone healing, offering a significant advantage over traditional uncoated nails in managing these complex injuries.