Treatment of open tibial shaft fractures using tightly fitted interlocking nailing.
Between 2000 and 2003 we treated 23 patients who sustained open tibial shaft fractures with tightly fitted interlocking intramedullary nailing. There were three grade I, eight grade II, nine grade IIIa, and three grade IIIb open fractures. Nail diameters were decided on using preoperative and intraoperative radiographs. Nails were introduced after gentle passage with a 7- to 8-mm hand reamer. Union was obtained in all cases. Nine (37.5%) fractures, however, required additional procedures before union. Three of them gained union through exchange nailing, bone graft, and bone transport, respectively. The remaining six underwent dynamisation. Two of them required an additional exchange nailing for non-union; thereafter one healed and the other gained union through an additional bone graft. Deep infection occurred in one case. Screw breakage occurred in one case only. Tightly fitted nailing produced a significantly lower incidence of locking screw breakage. However, even with this advantage, this technical modification has failed to show clinical advantage in terms of higher healing rate or lower rate of secondary procedures.
Department of Orthopaedic Surgery, Kyungpook National University Hospital, Taegu, South Korea. cwoh@kmu.ac.kr
Chang-Wug
CW
Oh
Su-Young
SY
Bae
Duk-Young
DY
Jung
Jong-Keon
JK
Oh
D000293:Adolescent; D000328:Adult; D000368:Aged; D001858:Bone Nails; D001863:Bone Screws; D005260:Female; D005594:Fracture Fixation, Intramedullary / Q000379:methods*; D005597:Fractures, Open / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000175:diagnosis; D016459:Prosthesis-Related Infections / Q000175:diagnosis; D013978:Tibial Fractures / Q000601:surgery*; D016896:Treatment Outcome