title: Reamed versus unreamed nail in the treatment of tibia shaft fractures.
abstract: OBJECTIVE
  The aim of the prospective randomized study was to compare the results of the treatment of tibia shaft fractures (TSF) by reamed or unreamed intramedullar nail.
  
  
  METHODS
  There were 103 patients with 104 TSF enrolled in the study within the period from December 2005 to June 2010. Seven patients were excluded from the study. Factors of injury severity, course of surgery and hospitalization, and incidence of early and delayed complications were recorded. X-ray was performed every 4 weeks until the fracture was healed. Functional results were evaluated at least 1 year after the surgery. Closed fractures were classified according to Tscherne classification and the open ones according to Gustilo classification.
  
  
  RESULTS
  Forty-eight patients with 49 TSF were treated by unreamed tibial nail. There were 15 women and 33 men in this group. Injury severity score (ISS) ranged from 4 to 25 (ø 6.63). There were 45 closed fractures (0 16; I 22; II 7) and four open fractures (I 2; II 1; IIIA 1). In the reamed nail group there were 48 TSF. ISS ranged from 4 to 18 (ø 6.13). There were 35 closed (0 17; I 13; II 5) and 13 open (I 5; II 5; IIIA 3) fractures in this group. The time of operation was on average 15 min shorter in the unreamed nail group. X-ray healing was the same in both groups (18.12 versus 17.92 weeks). We had four patients in the unreamed nail group and six patients in the reamed nail group with delayed healing (28-44 weeks). We recorded no infection, loss of reduction or re-operation in both groups. Follow-up of functional results was 90 %.
  
  
  CONCLUSIONS
  There was no statistically significant difference in clinical and functional results between the groups. We suggest that both methods are comparable.
authors.affiliation: Department of Surgery, University Hospital, Hradec Kralove, Czech Republic.
authors.forename: J
authors.initials: J
authors.lastname: Trlica
authors.affiliation: Department of Emergency Medicine, University Hospital, Hradec Kralove, Czech Republic.
authors.forename: J
authors.initials: J
authors.lastname: Kočí
authors.affiliation: Department of Field Surgery, Faculty of Military Health Sciences, University of Defence, Třebešská Street 1575, Hradec Kralove, 500 01, Czech Republic. lochmpet@yahoo.com.
authors.forename: P
authors.initials: P
authors.lastname: Lochman
authors.affiliation: Department of Field Surgery, Faculty of Military Health Sciences, University of Defence, Třebešská Street 1575, Hradec Kralove, 500 01, Czech Republic.
authors.forename: K
authors.initials: K
authors.lastname: Šmejkal
authors.affiliation: Department of Surgery, University Hospital, Hradec Kralove, Czech Republic.
authors.forename: M
authors.initials: M
authors.lastname: Frank
authors.affiliation: Department of Surgery, University Hospital, Hradec Kralove, Czech Republic.
authors.forename: T
authors.initials: T
authors.lastname: Holeček
authors.affiliation: Department of Surgery, University Hospital, Hradec Kralove, Czech Republic.
authors.forename: L
authors.initials: L
authors.lastname: Hasenöhrlová
authors.affiliation: Department of Surgery, University Hospital, Hradec Kralove, Czech Republic.
authors.forename: J
authors.initials: J
authors.lastname: Zahradníček
authors.affiliation: Department of Surgery, University Hospital, Hradec Kralove, Czech Republic.
authors.forename: J
authors.initials: J
authors.lastname: Folvarský
authors.affiliation: Department of Surgery, University Hospital, Hradec Kralove, Czech Republic.
authors.forename: I
authors.initials: I
authors.lastname: Žvák
authors.affiliation: Department of Surgery, University Hospital, Hradec Kralove, Czech Republic.
authors.forename: T
authors.initials: T
authors.lastname: Dědek
keywords: Reamed nail; Tibia shaft fracture; Unreamed nail
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