title: [Advantages of the unreamed tibial nail in comparison with external fixator in treatment of grade 3 B open tibial shaft fractures].
abstract: Between 1987 and 1993, 41 grade 3B open tibial shaft fractures were treated with the unreamed tibial nail (URTN n = 22) or an external fixator (FIX n = 19). The method of treatment was left to the choice of the operating surgeon. Three below the knee amputations were performed, three patients died, and three were lost to follow-up. In all, 32 patients were followed up to union or at least for 1 year. There were no significant statistical differences between the two groups (P < 0.2, chi-squared, t-test) with respect to fracture type, fracture location, age, gender or accompanying injuries. The URTN group showed significantly better results regarding time to full weight-bearing (URTN 11 +/- 4 weeks; FIX 20 +/- 11 weeks, P < 0.01 M-W) Mann-Whitney Test, number of reoperations (URTN 1.04; FIX 2.89; P < 0.01 M-W), isolated bone grafting (URTN 3/22; FIX 8/19; P < 0.05 chi-squared), and average Karlström and Olerud score (URTN 30 +/- 4; FIX 26 +/- 5; P < 0.05 M-W). In all, 15/17 URTN patients and only 6/15 FIX patients achieved unlimited walking distance (P < 0.01 M-W). Time to bony union, infection, and nonunion were not significantly different between groups.
authors.affiliation: Medizinische Hochschule Hannover.
authors.forename: P
authors.initials: P
authors.lastname: Schandelmaier
authors.forename: C
authors.initials: C
authors.lastname: Krettek
authors.forename: J
authors.initials: J
authors.lastname: Rudolf
authors.forename: A
authors.initials: A
authors.lastname: Kohl
authors.forename: H
authors.initials: H
authors.lastname: Tscherne
mesh_terms: D000328:Adult; D000671:Amputation, Surgical; D016267:External Fixators; D005260:Female; D005500:Follow-Up Studies; D005594:Fracture Fixation, Intramedullary / Q000295:instrumentation*; D017102:Fracture Healing / Q000502:physiology; D005597:Fractures, Open / Q000145:classification / Q000000981:diagnostic imaging / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011859:Radiography; D012086:Reoperation; D012189:Retrospective Studies; D013978:Tibial Fractures / Q000145:classification / Q000000981:diagnostic imaging / Q000601:surgery*; D016474:Weight-Bearing / Q000502:physiology