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The Journal of Bone and Joint Surgery, Vol 74, Issue 8 1162-1171, Copyright © 1992 by Journal of Bone and Joint Surgery, Inc
Treatment of open fractures of the tibial shaft with the use of interlocking nailing without reaming
AP Whittle, TA Russell, JC Taylor and DG Lavelle
Department of Orthopaedic Surgery, University of Tennessee-Campbell Clinic, Memphis 38103.
Fifty open fractures of the tibial shaft that were treated with debridement
and interlocking nailing without reaming were followed for an average of
twelve months. Most of the fractures were the result of high-energy trauma,
and 68 per cent of the fracture wounds were grade III. Forty-eight (96 per
cent) of the fifty fractures united at an average of seven months; there
were no malunions. There were four infections (8 per cent), all at the
sites of grade-III fractures. Locking screws broke in five tibiae (10 per
cent), but the breakage did not result in a loss of reduction. Three nails
broke, two at the sites of ununited fractures and one at the site of a
healed fracture. These results are comparable with, or better than, those
obtained with other forms of fixation, including immobilization with a
cast, unlocked intramedullary nailing, and external fixation.
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