Introduction

To study infection rates, radiological outcome (union) and functional outcome in open tibial shaft fracture cases managed with polylactic acid (PLA)-antibiotic coated nail. METHODS: 54 patients underwent debridement of wound, followed by open reduction and internal fixation with PLA-antibiotic coated nail (CE-certified, OSSIPRO, MatrixTM). The fully resorbable antibiotic coating consisted of polylactic acid matrix containing gentamicin sulphate. The thickness of antibiotic coating was 10 micrometers. Total drug in average size nail was 50 mg. RESULTS: 50 patients (40 open grade 2, 10 open grade 3a, Gustilo-Anderson classification) completed the minimum follow up of 6 months. Infection rate overall was 8% (4/50) (grade 2; 0% {0/40}, grade 3a; 40% {4/10}, P value 0.001). Union rate overall was 80% (4/50) (grade 2; 90% {36/40}, grade 3a; 40% {4/10}, P value 0.002). PCS (SF-36 score) at 6 months of follow up was 55.2 ± 20.10 (grade 2; 58.95 ± 9.99, grade 3a; 40.19 ± 16.37, P value 0.002) whereas MCS (SF-36 score) was 54.96 ± 23.5 (grade 2; 57.96 ± 16.63, grade 3a; 42.94 ± 23.75, P value 0.04). Infection rates reported in literature with the use of standard tibia nail are 3.5-10% and 5.1-15% for open grade 2 and grade 3 fractures respectively. CONCLUSION: The use of PLA-antibiotic coated nail in our study has shown promising results in open grade 2 fractures but not in grade 3 fractures. However, a larger sample size and a longer follow up would be required to further determine the usefulness of this implant.