The Effect of Topical Gentamicin after Open Reduction and Internal Fixation of Long Bone Fractures

Infection is a disastrous complication in orthopaedic surgery، because of poor blood supply of long bones and usage of metal devices. The aim of this study was to evaluate the effect of adding topical gentamicin to the surgical wound after open reduction and internal fixation of a long bone fracture.

In a clinical trial، 120 patients who were candidates for open reduction and internal fixation of a long bone fracture in a training hospital in Bandar Abbass، Iran were divided into two equal groups (60 patients each). Routine prophylactic standard systemic antibiotic regimen was used in both groups. In the «case group»، gentamicin was used topically in operation site in addition to the systemic regimen. All the patients were followed at least for 6 months and observed for superficial and or deep infection signs and symptoms.

In the control group، 12 infections were observed، 7 of which were superficial and cleared with antibiotic and wound care. In the study group only 3 superficial and no deep infections was found. Statistical analysis revealed that both superficial and deep infection rates were significantly lower in the study group (p=. 01).

Prophylactic topical use of gentamicin in addition to the systemic regimen can be effective in reducing the rate of infection after open reduction and internal fixation of long bone fractures.