Secondary intramedullary nailing of the tibia in an animal model of an external fixation pin track infection

Abstract

This thesis discusses the management of military tibial fractures and develops the hypothesis that secondary intramedullary nailing after initial external fixation may be the optimum method of stabilisation for high-energy military fractures. An in vitro long bone model was developed to determine the spread of contamination following a ballistic fracture. This demonstrated that the contamination was limited to the fracture site and, therefore, that external fixator pins could be safely inserted through uncontaminated areas.

Using a previously established model of a pin track infection, secondary intramedullary nailing was carried out in an in vivo ovine model. This confirmed previous clinical findings of widespread infection. Using this model a treatment group was studied when conventional methods of treating infection were utilised. Despite an increase in survival time, and an improved clinical course, 5 of 6 animals still had bacteriological evidence of infection, and all 6 animals had histological evidence of infection at post-mortem.

Although the technique of secondary intramedullary nailing has potential in the management of military tibial fractures, it cannot be recommended on the basis of this work. This model, however, could be used to study other techniques of infection control, and this is also discussed in this thesis.

More information

Identifiers

Catalogue record

Export record

ASCII CitationAtomBibTeXData Cite XMLDublin CoreDublin CoreEP3 XMLEndNoteHTML CitationHTML CitationHTML ListJSONMETSMODSMPEG-21 DIDLOpenURL ContextObjectOpenURL ContextObject in SpanRDF+N-TriplesRDF+N3RDF+XMLRIOXX2 XMLReferReference ManagerSimple Metadata