title: Expandable nailing system for tibial shaft fractures.
abstract: OBJECTIVE
  To evaluate and present our current clinical experience in the treatment of closed and open tibial shaft fractures using the expandable intramedullary nailing system.
  
  
  METHODS
  Prospective study.
  
  
  METHODS
  One level-1 trauma centre.
  
  
  METHODS
  Twenty-six patients with acute tibial shaft fractures with at least 10 cm of intact cortex on both sides of the fracture.
  
  
  METHODS
  Internal fixation using the Fixion expandable intramedullary nail (Disc-O-Tech Medical Technologies Ltd., Herzliya, Israel).
  
  
  METHODS
  Operative and fluoroscopy time, healing time and perioperative complications were recorded.
  
  
  RESULTS
  Twenty-six tibial fractures were treated (OTA classification: 3 type A1, 8 A2, 8 A3, 3 B1, 3 B2, and 1 B3), six of which were open. All fractures healed by week 18.5 with an mean of 12.8+/-3.8 weeks. The operating time ranged from 20 to 50 min with an mean of 40+/-12.17 min. The fluoroscopy time ranged from 6 to 22s with a mean of 10+/-5s. In one case the nail failed to expand, as detected by X-ray control, and had to be exchanged intraoperatively. Two patients reported anterior knee pain during the follow up, but did not wish any further treatment. In a low demanding patient rotational malalignment was noted and no further action needed.
  
  
  CONCLUSIONS
  According to the results of this study, the use of the Fixion nailing system, where indicated, is associated with minimal complications and very good functional outcomes in fractures OTA types A and B. The advantages of the expandable nail include the decrease in the operating and fluoroscopy time and the simplicity of its application.
authors.affiliation: 2nd Orthopaedic Department, Panarcadian General Hospital, Tripolis, Greece.
authors.forename: A P
authors.initials: AP
authors.lastname: Fortis
authors.forename: A
authors.initials: A
authors.lastname: Dimas
authors.forename: A A
authors.initials: AA
authors.lastname: Lamprakis
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001858:Bone Nails / Q000191:economics / Q000592:standards*; D004867:Equipment Design; D005260:Female; D005594:Fracture Fixation, Intramedullary / Q000295:instrumentation*; D017102:Fracture Healing; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011859:Radiography; D011877:Radionuclide Imaging; D013977:Tibia / Q000000981:diagnostic imaging / Q000293:injuries / Q000601:surgery*; D013978:Tibial Fractures / Q000000981:diagnostic imaging / Q000601:surgery*; D016896:Treatment Outcome; D016474:Weight-Bearing / Q000502:physiology