Preliminary outcomes of a novel metal-coated antibacterial nail in Bone Transport Over Nail (BTON) and Nail After Bone Transport (NABT) procedures in cases of segmental infected tibial bone defects
Objective: To evaluate the clinical outcomes of a novel hybrid bone transport technique using an antibacterial-coated nail for the treatment of infected segmental tibial bone defects. Methods: This retrospective study included 19 patients with infected segmental tibial bone defects treated using hyb...
| Autores: | , , , , , |
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| Tipo de recurso: | artículo |
| Fecha de publicación: | 2025 |
| País: | España |
| Institución: | Universitat Autònoma de Barcelona |
| Repositorio: | Dipòsit Digital de Documents de la UAB |
| Idioma: | inglés |
| OAI Identifier: | oai:ddd.uab.cat:313560 |
| Acceso en línea: | https://ddd.uab.cat/record/313560 https://dx.doi.org/urn:doi:10.1016/j.injury.2025.112520 |
| Access Level: | acceso embargado |
| Palabra clave: | Bone defect Fracture-related infection Bone Transport Ilizarov technique Truelok Intramedullary Nail Infection complications Bactiguard |
| Sumario: | Objective: To evaluate the clinical outcomes of a novel hybrid bone transport technique using an antibacterial-coated nail for the treatment of infected segmental tibial bone defects. Methods: This retrospective study included 19 patients with infected segmental tibial bone defects treated using hybrid bone transport with an antibacterial-coated nail, the ZNN™ Bactiguard® nail. Patients were divided into two groups: nailing after bone transport (NABT, n = 11) and bone transport over nail (BTON, n = 8). These groups were compared with a control group of 10 infected patients treated with conventional external fixation bone transport (EFBT). The primary endpoint was infection eradication, while secondary endpoints included external fixation time (EFT), external fixation index (EFI), complications, and bone regeneration quality. Results: The mean external fixation time (EFT) for the entire cohort was 280.2 ± 142.7 days. The BTON group had the shortest EFT (150 ± 45 days), significantly lower than both NABT (279 ± 99 days) and EFBT (927 ± 1710 days, p = 0.001). The external fixation index (EFI) was also significantly lower for BTON compared to EFBT (25 ± 10.7 vs. 77.5 ± 38.7 days/cm, p = 0.009). A single case of a recurrent infection was reported in the BTON group (5.3 %), which was managed with nail removal and the continuation of external fixation bone transport without further complications. The infection was fully resolved in all cases (29/29) at the end of the follow-up period. Complication rates were similar across groups. The primary docking site union rate was 89.7 %, with no significant differences between groups. Conclusions: The BTON technique using an antibacterial-coated nail reduces EFT by threefold compared to traditional external fixation bone transports methods, without increasing complications. A notable reduction was also observed in the NABT group, although it did not reach statistical significance. This approach offers a promising alternative to conventional methods for the treatment of infected tibial bone defects. |
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