Tibial shaft fractures treated with the AO unreamed tibial nail.
BACKGROUND
The AO unreamed tibial nail (UTN) has been used for both open and closed tibial fractures. The reported results have been mixed. We evaluated its outcome in our unit.


OBJECTIVE
To assess the outcome of tibial shaft fractures treated with the AO UTN.


METHODS
Forty-eight patients underwent intramedullary nailing between 1995 and 2000 using the AO UTN. Follow-up details were available for 45 patients.


RESULTS
Forty-four fractures united (97%). Complications included one non-union (2.2%), 15 delayed unions (33%), nine had either broken or bent interlocking screws (20%), six malunions (13%) and three patients underwent fasciotomy for compartment syndrome (7%). Twenty-one patients underwent at least one additional operation to obtain union (47%). Of these, five underwent exchange nailing (11%).


CONCLUSIONS
The AO UTN does have a high complication rate and, should it be used, we feel that early dynamisation or exchange nailing be considered to hasten union and prevent screw breakage.
Kutty
S
S
Department of Trauma and Orthopaedics, The Adelaide Hospital, Dublin, Ireland. kuttysatish@hotmail.com
Farooq
M
M
Murphy
D
D
Kelliher
C
C
Condon
F
F
McElwain
J P
JP
D000293:Adolescent; D000328:Adult; D001858:Bone Nails; D005260:Female; D005594:Fracture Fixation, Intramedullary; D017102:Fracture Healing; D005596:Fractures, Closed / Q000601:surgery; D005597:Fractures, Open / Q000601:surgery; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D013978:Tibial Fractures / Q000601:surgery*; D013997:Time Factors