Nonreamed nailing of closed and minor open tibial fractures in patients with blunt polytrauma.
A retrospective comparison of dynamic and static locking mode nonreamed nails in 88 closed, Grades I and II open tibial fractures is presented. Amount of time and number of reoperations required to unite fractures were compared for dynamic (Group 1, n = 31) and static locked (Group 2, n = 13) Winquist I and II fractures, and dynamic (Group 3, n = 14) and static locked (Group 4, n = 30) Winquist III, IV, and segmental fractures. Total reoperations also were compared; Tibias treated with dynamic nails united in an average of 20 weeks, with 3 reoperations; tibias treated with static locked nails united in an average of 30 weeks, with 21 reoperations. Group 1 fractures united in an average of 20 weeks, with 1 reoperation; Group 2 fractures united in an average of 32 weeks, with 4 reoperations. Group 3 fractures united in an average of 20 weeks; Group 4 fractures united in an average of 29 weeks, with 11 reoperations. In the group of tibias treated with dynamic nails, 3 additional operations were done; in the group of tibias treated with static locked nails, 7 additional operations were done. There was 1 infection and 3 deformities. Static locking mode appeared to delay union, especially when Groups 1 and 2 are compared; these fractures can be nailed without locking screws.
Riemer
B L
BL
Department of Orthopaedic Surgery, Allegheny General Hospital, Medical College of Pennsylvania, Pittsburgh, USA.
Miranda
M A
MA
Butterfield
S L
SL
Burke
C J
CJ
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001858:Bone Nails; D005260:Female; D005594:Fracture Fixation, Intramedullary / Q000295:instrumentation*; D017102:Fracture Healing; D006801:Humans; D008297:Male; D008875:Middle Aged; D009104:Multiple Trauma; D012086:Reoperation; D012189:Retrospective Studies; D013978:Tibial Fractures / Q000601:surgery*; D013997:Time Factors; D014949:Wounds, Nonpenetrating / Q000150:complications