Table 3 Inclusion and exclusion criteria

1. Age ≥ 18 years

1. Time from injury to presentation > 48 h

2. Open tibial shaft fracture meeting the following criteria:

2. Time from injury to surgery > 7 days

 a. OTA type 42

3. Aminoglycoside allergy

 b. Primarily closable wound

4. GA IIIB or IIIC open fractures

 c. GA I, II, or IIIA

5. Bilateral open tibia fractures

6. Severe brain (GCS < 12) or spinal cord injury

7. Severe vascular injury

8. Severe burns (> 10% TBSA or > 5% TBSA with full thickness or circumferential injury)

9. Pathologic fracture

10. History of ipsilateral active limb infection

11. Unlikely to complete follow-up