[Initial experiences with the unreamed tibial nail].
During a one-year period starting January 1991, 17 tibial shaft fractures have been treated with the new AO unreamed tibial nail in a prospective study. Fractures were classified according to the AO classification: 10 type A, 6 type B, one type C. 7 fractures were closed. Out of those 3 showed marked soft tissue contusions and 2 required a fasciotomy because of a concomitant compartment syndrome. The open fractures were classified according to the Gustilo classification: 3 grade I, 5 grade II, 1 grade III B and 1 grade III C injury. There were 5 polytraumatised patients (ISS 27-34). The nailing procedure was preformed on the day of admission in 11 cases and in a delayed fashion (2-14 days after the accident) in 6 cases. There were no specific technical problems encountered intraoperatively. The only perioperative complication consisted of 1 case of fat embolism syndrome. 1 fracture required secondary plate osteosynthesis because of a unacceptable valgus deformity 6 weeks postoperatively. There was 1 too long nail implanted at the initial surgery, which then had to be changed during the rehabilitation period because of pain in the region of the knee. In 3 cases the interlocking bolts broke and 3 other cases required secondary dynamisation. There was a complete follow-up in all cases of at least 6 months. There were no infections. All fractures are healed. Full weight bearing was allowed at a mean of 10 weeks for closed fractures and 14 weeks for open fractures, respectively. All but one fracture (valgus 8 degrees) healed in a correct axial alignment without shortening.(ABSTRACT TRUNCATED AT 250 WORDS)
Renner
N
N
Departement Chirurgie, Kantonsspital Basel.
Regazzoni
P
P
Babst
R
R
Rosso
R
R
D000293:Adolescent; D000328:Adult; D000368:Aged; D001858:Bone Nails; D005260:Female; D005500:Follow-Up Studies; D005594:Fracture Fixation, Intramedullary / Q000295:instrumentation*; D017102:Fracture Healing / Q000502:physiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D013978:Tibial Fractures / Q000503:physiopathology / Q000601:surgery*
Erste Erfahrungen mit dem unaufgebohrten Tibianagel (unreamed tibial nail, UTN).