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Research Journal of Medical Sciences

ISSN: Online 1993-6095
ISSN: Print 1815-9346
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Gentamicin‐Coated Tibia Nail in Fractures and Nonunion to Reduce Fracture‐Related Infections: A Systematic Review

Zakir Hussain Mohamed, K.C. Mathew, S. Kavin Raja, A. Mohamed Zubair, G. Rohin and T.T. Annamalai
Page: 761-766 | Received 25 Oct 2024, Published online: 31 Dec 2024

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https://doi.org/10.36478/makrjms.2024.12.761.766

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Abstract

Open tibial fractures and nonunion cases carry a high risk of fracturerelated infections (FRI), often requiring advanced strategies to mitigate complications. Gentamicin‐coated intramedullary nails have been proposed as a localized antibiotic delivery system to prevent infections without systemic side effects. This systematic review aimed to evaluate the efficacy and safety of gentamicin‐coated tibial nails in fracture fixation (FF) and revision surgeries (RS) for nonunion, with a specific focus on FRI incidence, healing outcomes and adverse effects. A systematic search of PubMed, Cochrane and EMBASE databases was conducted following PRISMA guidelines. Studies were selected based on predefined inclusion criteria, with data extracted and analyzed from eight eligible studies comprising 203 patients. Outcomes assessed included FRI incidence, superficial surgical site infections (SSI), bone healing, nonunion rates and reoperation requirements. Among 114 FF cases, 63% were open fractures and the FRI rate was 3.81%. Bone healing was achieved in 76.2%, with nonunion in 5.7%. In the RS group (n=89), which included 43% infected nonunion cases, the FRI rate was 6.49%, bone healing occurred in 83.1% and nonunion persisted in 11.7%. No systemic adverse effects related to gentamicin were reported in either group. Gentamicin‐coated tibial nails demonstrate promising efficacy in reducing FRI rates, particularly in high‐risk open fractures and nonunion cases. Their favorable safety profile and local antibiotic delivery mechanism support their clinical utility, although further high‐quality randomized trials are warranted to confirm these findings and refine indications.

How to cite this article:

Zakir Hussain Mohamed, K.C. Mathew, S. Kavin Raja, A. Mohamed Zubair, G. Rohin and T.T. Annamalai. Gentamicin‐Coated Tibia Nail in Fractures and Nonunion to Reduce Fracture‐Related Infections: A Systematic Review.
DOI: https://doi.org/10.36478/10.36478/makrjms.2024.12.761.766
URL: https://www.makhillpublications.co/view-article/1815-9346/10.36478/makrjms.2024.12.761.766