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Published in: European Journal of Orthopaedic Surgery & Traumatology 1/2020

01-01-2020 | Bone Infection | Original Article • LOWER LIMB - INFECTION

Does an antibiotic nail made in a lubricated tube release antibiotic?

Authors: Jonathon R. Lindner, David Seligson, Ernest Chisena, Saeed A. Jortani, Erik A. Korte

Published in: European Journal of Orthopaedic Surgery & Traumatology | Issue 1/2020

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Abstract

Introduction

The treatment of long-bone osteomyelitis has long been a difficult problem. Recently, antibiotic-impregnated intramedullary rods for the treatment of infected long-bone fractures have been gaining popularity but they are quite difficult to fabricate. Recently, a new technique that utilizes mineral oil to coat the inside of a chest tube mold prior to introduction of cement has been proven to ease fabrication. We hypothesized that the use of mineral oil would alter the elution characteristics of tobramycin from the intramedullary device.

Methods

Two groups of antibiotic nails were fabricated under sterile conditions. The control group utilized a chest tube mold. The study group utilized a chest tube that was coated with mineral oil prior to cement injection. Each intramedullary nail was placed in pooled human serum and incubated under physiologic conditions. The level of tobramycin in each sample was measured at timepoints 0, 1, 6, and 24 h.

Results

There was no significant difference when comparing control with the experimental group at any timepoint. Antibiotic nails eluted tobramycin at a rapid rate in the first 6 h of exposure to serum, regardless of their preparation with oil or without oil. The rate of elution fell precipitously between 6 and 24 h.

Conclusion

We believe that although this study, as with any study, cannot perfectly recreate in vivo conditions, we have clearly shown that mineral oil has no significant effect on elution of tobramycin from antibiotic nails.
Literature
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go back to reference Klaus Klemm SH, Seligson D (1988) The treatment of infection after interlocking nailing. Tech Orthop 3:54–61CrossRef Klaus Klemm SH, Seligson D (1988) The treatment of infection after interlocking nailing. Tech Orthop 3:54–61CrossRef
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go back to reference Madanagopal SG, Seligson D, Roberts CS (2004) The antibiotic cement nail for infection after tibial nailing. Orthopedics 27(7):709–712CrossRef Madanagopal SG, Seligson D, Roberts CS (2004) The antibiotic cement nail for infection after tibial nailing. Orthopedics 27(7):709–712CrossRef
Metadata
Title
Does an antibiotic nail made in a lubricated tube release antibiotic?
Authors
Jonathon R. Lindner
David Seligson
Ernest Chisena
Saeed A. Jortani
Erik A. Korte
Publication date
01-01-2020
Publisher
Springer Paris
Published in
European Journal of Orthopaedic Surgery & Traumatology / Issue 1/2020
Print ISSN: 1633-8065
Electronic ISSN: 1432-1068
DOI
https://doi.org/10.1007/s00590-019-02533-0

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