[Study on experimental suppurative osteomyelitis--influence of an intramedullary nail on infection in open fractures]

Studies were conducted on temporary intramedullary fixation of open fractures containing pathogens to determine the degree of involvement of metal splints in the "establishment of infection" and whether or not there is a so-called "golden hour" for antibiotic administration. An open fracture was experimentally produced in the tibia of mice and inoculated with 10(2) or 10(3) cells of staphylococcus aureus. Two separate groups of intramedullary fixation and plaster cast fixation were compared. In the intramedullary fixation group, infection was established in 77.8% of the mice inoculated with 10(2) bacteria and in 100% of those inoculated with 10(3) cells, compared with 35.0% and 70.0% in the plaster cast fixation group. When antibiotic administration was started 12 hours after the inoculation, 4 of 5 mice of the intramedullary fixation group inoculated with 10(3) cells showed abundant bacterial cells after 2 weeks. Antibiotic administration started 6 hours after the inoculation achieved bacterial elimination in all mice.