Unreamed Tibial Nailing in Open Tibial Shaft Fractures

Abstract

Aim: Intramedullary nailing has been considered as treatment of choice for tibial shaft fracture. There is still a debate whether to do reamed or undreamed tibial nailing in open fracture as both have merits and demerits. We have performed undreamed tibial nailing in Gustilo and Anderson (GA) Type 3-A open tibial shaft fractures and evaluated the results. Methods: The prospective cohort study was done using non-probability consecutive sampling technique.We operated 85consecutive patients with GA Type 3-A open tibial shaft fractures. Standard intra medullary nailing was done without reaming the medullary canal. Eightypatients were followed up to four years and four months& 5 patients lost to follow up. The time of union, infection, delayed union, hardware failure,non-union and compartment syndrome and any secondary procedure to achieve union were recorded. Results: Out of the total 85 participants there were 36 (42.35%) male and 49 (57.65%) were females.The mean age of the patients was 30.25±12.01 years (16 to 58 years). The primary union rate was 70% (56 patients). There were 15 (18.75%) delayed union and 9(11.25%) non-union. The average time of union was 23.57±2.347 weeks (9- 28 weeks). Moreover, there were 9(11.25%) superficial and 7(7.5%) deep infections. Three (3.75%) nail failure and four screw breakages. Conclusion: This study showed a possible benefit of un-reamed intramedullary nailing for open 3A fracture of Tibia.