Treatment of tibial fractures by Reamed intramedulary nailing.

Abstract

One hundred and fifteen cases of tibial fractures (in 114 patients) treated by debridement,open reduction, reaming of the medullary canal, and stabilized with an intramedullary nail were reviewed. The patients were 95 males, 19 females and the mean age was 32.96 years.73.9 percent of the fractures were caused by traffic accident. Ninety fractures were located at the middle third of tibia. Thirty ones were determined unstable. 18 fractures were fixed by dynamically locked mode, 17 fractures by non-locked intramedullary nails with cerclage wiring and the others by non-locked intramedullary nailing. Follow-up showed union in all. Time to union averaged 14.96 weeks (range 8-37 weeks). Delayed union was observed totally 8.6 percent.only 2.6 percent required secondary bone grafting to get union. Deep infection developed in 5.8 percent of the closed fractures, 14.1 percent of the open ones. How to manage delayed union and osteomeyelitis were described.