Infection development in open distal tibial fractures: A comparison of standard titanium plate applications with silver-coated titanium plate applications

Öz

Aim: In this study, we aimed to compare standard titanium plates and silver-Coated titanium plates used for osteosynthesis in open distal tibial fractures, in terms of infection development. Methods: We investigated the development of infection in 216 patients who were operated on based on the principles of biological fixation for Gustilo-Anderson Type 1 and type 2 open distal tibial fractures between 2008 and 2016. 

Standard titanium plates were used in 112 patients (51.9%) (Group 1) and silver-coated titanium plates were used in 104 patients (48.1%) (Group 2). In Group 1, 68 patients had Type 1 and 44 patients had Type 2 open fractures. In Group 2, 58 patients had Type 1, 46 patients had Type 2 open fractures. Results: Infection developed in sixteen patients in Group 1 (five patients with Type 1 and eleven patients with Type 2 fractures, 14.3%) and in three patients (2.9%) with Type 2 open fractures in Group 2. The development of infection was significantly lower in the group that underwent osteosynthesis using silver-coated titanium plates (p<0.05). No statistically significant difference was detected between the groups in terms of time to union (p>0.05). 17 patients in Group 1 and 22 patients in Group 2 had delayed union. There were no statistical differences between two groups in terms of case numbers showing delayed union (p>0.05). Delayed union was observed in all patients who developed infection. Conclusion: Osteosynthesis of open distal tibial fractures with silver-coated titanium plates was found to be effective in preventing infection. Based on our observations, coating the implant with silver did not have any impact on fracture union.

Anahtar Kelimeler

• Open fractures,osteosynthesis,infection,biofilm,silver

Açık distal tibia kırıklarında enfeksiyon gelişimi: Standart titanyum plak ile gümüş kaplı titanyum plak uygulamaları karşılaştırması

Öz

Amaç: Bu çalışmada, standart titanyum plak ve gümüş kaplı titanyum plak ile osteosentez yapılan açık distal tibia kırıklarında enfeksiyon gelişimini karşılaştırmayı amaçladık. Yöntem: Gustilo-Anderson tip 1 ve tip 2 açık distal tibia kırığı nedeniyle 2008-2016 tarihleri arasında biyolojik tesbit prensipleri ile ameliyat edilen ve iki yılın üzerinde takibi yapılan 216 olguda enfeksiyon gelişimi araştırıldı. Standart distal tibia titanyum plak 112 (%51.9) hastada (Grup 1), gümüş kaplı distal tibia titanyum plak 104 (%48.1) hastada (Grup 2) kullanıldı. Grup 1 de 68 hastada tip 1, 44 hastada tip 2 açık kırık vardı. Grup 2 de ise 58 hastada tip tip 1, 46 hastada tip 2 açık kırık mevcuttu. Bulgular: Grup 1 de 16 (tip 1’de beş hasta, tip 2’de onbir hasta, %14.3) hastada, Grup 2 de tip 2 açık kırıklı üç (%2.9) hastada enfeksiyon gelişti. Enfeksiyon gelişimi gümüş kaplı titanyum plak ile osteosentez yapılan grupta anlamlı derecede düşük bulundu (p<0.05). Gruplar arasında kaynama süreleri açısından istatistiksel fark bulunmadı (p>0.05).  Grup 1’de 17 hasta, Grup 2’de 22 hastada kaynama gecikmesi tesbit edildi. İki grup arasında kaynama gecikmesi gösteren olgu sayıları açısından istatistiksel fark yoktu (p>0.05). Enfeksiyon gelişen hastalarda aynı zamanda kaynama gecikmesi de saptandı. Sonuç: Gümüş kaplı titanyum plak ile açık distal tbia kırıklarının osteosentezi enfeksiyonu önlemede etkin bulundu. İmplantın gümüş ile kaplanmasının kırık kaynaması üzerinde etkisi tesbit edilmedi.

Anahtar Kelimeler

• Açık kırıklar,osteosentez,enfeksiyon,biyofilm,gümüş

Kaynakça

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