title: What's in a nail?
abstract: To determine the incidence of subclinical infection using routine swab methods in asymptomatic patients, 30 consecutive hollow intramedullary nails were studied. Variables identified were leukocyte count and differential, patient complaints, time elapsed from injury to nail implantation, duration of nail implantation, and the size of the nail. Specimens were gathered from the lumen of intramedullary nails using the routine swab method for bacterial culture as well as fungal and acid-fast growth. This material was also subjected to pathologic review with routine hematoxylin and eosin staining. There were no significant positive cultures in this study. The pathologic review indicated that the material in the canal of an intramedullary nail was either granulation tissue, fibrous tissue, or osseous tissue. No patient had a deep or superficial wound infection after implant removal. The results of this study indicate that the material in the lumen of the hollow intramedullary nail will fail to grew organisms when the swab method is used in gathering the specimen or the material is sent for quantitative bacteriology.
authors.affiliation: Department of Orthopedic Surgery, University of Louisville, Kentucky 40207.
authors.forename: P J
authors.initials: PJ
authors.lastname: Singer
authors.forename: D
authors.initials: D
authors.lastname: Seligson
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001858:Bone Nails; D005260:Female; D005264:Femoral Fractures / Q000601:surgery; D005594:Fracture Fixation, Intramedullary / Q000295:instrumentation*; D006097:Granulation Tissue / Q000382:microbiology* / Q000473:pathology; D006801:Humans; D008297:Male; D008875:Middle Aged; D013530:Surgical Wound Infection / Q000382:microbiology; D013978:Tibial Fractures / Q000601:surgery