ROLE OF ANTIBIOTIC COATED INTRAMEDULLARY RUSHNAIL IN MANAGEMENT OF GRADE IIIB COMPOUND FRACTURES OF TIBIA

Abstract

Background:
Grade IIIB compound tibial fractures are characterized by severe soft tissue injury and
contamination, posing a high risk for infection and nonunion. Traditional fixation methods
often result in complications. Antibiotic-coated intramedullary Rush nails offer both
mechanical stabilization and localized antibiotic delivery, potentially improving outcomes.
Objectives:
To evaluate the effectiveness of antibiotic-coated intramedullary Rush nails in managing Grade IIIB open tibial fractures, focusing on union rates, infection control, and functional
recovery.
Methods:
A prospective observational study was conducted on 30 patients with Grade IIIB open tibial
fractures treated using custom-fabricated Rush nails coated with PMMA cement impregnated
with vancomycin and/or gentamicin. Patients were followed up for a minimum of 9 months.
Outcomes were assessed using radiological union criteria, infection rates, time to full weightbearing, and functional status.
Results:
Of the 30 patients, 28 (93.3%) achieved fracture union within a mean duration of 21.3 ± 4.6
weeks. Three patients (10%) developed deep infections, of whom two required surgical
debridement. Functional outcomes, as assessed by lower extremity functional scales, weresatisfactory in 25 patients (83.3%). There were no cases of implant failure or systemic
antibiotic complications.
Conclusion:
Antibiotic-coated intramedullary Rush nails provide an effective and affordable treatment
modality for Grade IIIB tibial fractures. This approach ensures stable fixation, promotes bone
healing, and significantly reduces the risk of deep infection, especially in resourceconstrained settings. The technique may serve as a reliable alternative to conventional treatment strategies in managing severe open tibial injuries.