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...

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Authors: Corona Pérez-Cardona, Pablo S.|||0000-0003-4128-3142, Pujol, Oriol|||0000-0003-4760-2730, García Valcárcel, Jorge, Vicente Gomà-Camps, Matías|||0000-0002-9404-9299, Lakhani, Kushal|||0000-0001-8801-2839, Amat, Carles|||0000-0002-3057-0595
Format: article
Publication Date:2025
Country:España
Institution:Universitat Autònoma de Barcelona
Repository:Dipòsit Digital de Documents de la UAB
Language:English
OAI Identifier:oai:ddd.uab.cat:313560
Online Access:https://ddd.uab.cat/record/313560
https://dx.doi.org/urn:doi:10.1016/j.injury.2025.112520
Access Level:Embargoed access
Keyword:Bone defect
Fracture-related infection
Bone Transport
Ilizarov technique
Truelok
Intramedullary Nail
Infection complications
Bactiguard
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spelling 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 defectsCorona Pérez-Cardona, Pablo S.|||0000-0003-4128-3142Pujol, Oriol|||0000-0003-4760-2730García Valcárcel, JorgeVicente Gomà-Camps, Matías|||0000-0002-9404-9299Lakhani, Kushal|||0000-0001-8801-2839Amat, Carles|||0000-0002-3057-0595Bone defectFracture-related infectionBone TransportIlizarov techniqueTruelokIntramedullary NailInfection complicationsBactiguardObjective: 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.Universitat Autònoma de Barcelona 220252025-01-0120262026-06-30Articlehttp://purl.org/coar/resource_type/c_6501AMhttp://purl.org/coar/version/c_ab4af688f83e57aainfo:eu-repo/semantics/articlehttps://ddd.uab.cat/record/313560https://dx.doi.org/urn:doi:10.1016/j.injury.2025.112520reponame:Dipòsit Digital de Documents de la UABinstname:Universitat Autònoma de BarcelonaInglésengembargoed accesshttp://purl.org/coar/access_right/c_f1cfAquest material està protegit per drets d'autor i/o drets afins. Podeu utilitzar aquest material en funció del que permet la legislació de drets d'autor i drets afins d'aplicació al vostre cas. Per a d'altres usos heu d'obtenir permís del(s) titular(s) de drets.https://rightsstatements.org/vocab/InC/1.0/info:eu-repo/semantics/embargoedAccessoai:ddd.uab.cat:3135602026-06-06T12:50:31Z
dc.title.none.fl_str_mv 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
title 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
spellingShingle 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
Corona Pérez-Cardona, Pablo S.|||0000-0003-4128-3142
Bone defect
Fracture-related infection
Bone Transport
Ilizarov technique
Truelok
Intramedullary Nail
Infection complications
Bactiguard
title_short 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
title_full 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
title_fullStr 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
title_full_unstemmed 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
title_sort 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
dc.creator.none.fl_str_mv Corona Pérez-Cardona, Pablo S.|||0000-0003-4128-3142
Pujol, Oriol|||0000-0003-4760-2730
García Valcárcel, Jorge
Vicente Gomà-Camps, Matías|||0000-0002-9404-9299
Lakhani, Kushal|||0000-0001-8801-2839
Amat, Carles|||0000-0002-3057-0595
author Corona Pérez-Cardona, Pablo S.|||0000-0003-4128-3142
author_facet Corona Pérez-Cardona, Pablo S.|||0000-0003-4128-3142
Pujol, Oriol|||0000-0003-4760-2730
García Valcárcel, Jorge
Vicente Gomà-Camps, Matías|||0000-0002-9404-9299
Lakhani, Kushal|||0000-0001-8801-2839
Amat, Carles|||0000-0002-3057-0595
author_role author
author2 Pujol, Oriol|||0000-0003-4760-2730
García Valcárcel, Jorge
Vicente Gomà-Camps, Matías|||0000-0002-9404-9299
Lakhani, Kushal|||0000-0001-8801-2839
Amat, Carles|||0000-0002-3057-0595
author2_role author
author
author
author
author
dc.contributor.none.fl_str_mv Universitat Autònoma de Barcelona
dc.subject.none.fl_str_mv Bone defect
Fracture-related infection
Bone Transport
Ilizarov technique
Truelok
Intramedullary Nail
Infection complications
Bactiguard
topic Bone defect
Fracture-related infection
Bone Transport
Ilizarov technique
Truelok
Intramedullary Nail
Infection complications
Bactiguard
description 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.
publishDate 2025
dc.date.none.fl_str_mv
2
2025
2025-01-01
2026
2026-06-30
dc.type.none.fl_str_mv Article
http://purl.org/coar/resource_type/c_6501
AM
http://purl.org/coar/version/c_ab4af688f83e57aa
dc.type.openaire.fl_str_mv info:eu-repo/semantics/article
format article
dc.identifier.none.fl_str_mv https://ddd.uab.cat/record/313560
https://dx.doi.org/urn:doi:10.1016/j.injury.2025.112520
url https://ddd.uab.cat/record/313560
https://dx.doi.org/urn:doi:10.1016/j.injury.2025.112520
dc.language.none.fl_str_mv Inglés
eng
language_invalid_str_mv Inglés
language eng
dc.rights.none.fl_str_mv embargoed access
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https://rightsstatements.org/vocab/InC/1.0/
dc.rights.openaire.fl_str_mv info:eu-repo/semantics/embargoedAccess
rights_invalid_str_mv embargoed access
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https://rightsstatements.org/vocab/InC/1.0/
eu_rights_str_mv embargoedAccess
dc.source.none.fl_str_mv reponame:Dipòsit Digital de Documents de la UAB
instname:Universitat Autònoma de Barcelona
instname_str Universitat Autònoma de Barcelona
reponame_str Dipòsit Digital de Documents de la UAB
collection Dipòsit Digital de Documents de la UAB
repository.name.fl_str_mv
repository.mail.fl_str_mv
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