Abstract:

Background: Tibial fractures are the most common of all long bone fractures. Although many tibial fractures may be managed conservatively, a certain subset, including unstable fractures and open fractures, require operative stabilization. Intramedullary nails have become the popular choice of implant in the treatment of tibial shaft fractures. The choice between reamed and unreamed intramedullary nailing fort he treatment of open and closed tibial fractures is an ongoing controversy. The aim of this retrospective study was to evaluate the functional and radiological results of open versus closed tibial shaft fractures treated with reamed intramedullary nailing. Methods: The study included 24 patients 5 woman and 19 man who underwent surgical treatment with intramedullary nailing for tibial shaft fractures. Patients were divided into two groups. Group 1 Open fracture included 13 patients mean age: 31.7±10.7 years . Group 2 Closed fracture consisted of 11 patients mean age: 33.4±11.4 years . Functional and radiologic results were assessed. Johner-Wrush criteria was used for functional assessment. Results: Mean follow-up periods of 25.3±11.5 months and 23.7±12.6 months in group 1 and group 2, respectively. The distrubition of fracture types according to AO classification between the two groups was similar. There was no significant difference between the two groups in terms of functional and radiological results. All fractures healed with solid union within a mean of 17.3±6.4 weeks, and there was no complication that was expected to cause permanent disability. Two patients required dynamization because of delayed union without any other additional procedures. Transient sensorial deficit occured in one patient. According to the Johner-Wrush criteria, functional results were very good in 16 patients 67% , and good in 8 patients 33% . Conclusions: Surgical treatment of tibial diaphysis fractures with reamed and locked intramedullary nailing is an appropriate choice with a low complication rate. It can be safely used in moderately contaminated open fractures. However, success of the application, in accordance with, depends on the determination of an accurate indication as well as the surgical technique

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