Syed Baqir Hussain Jafree, Adeel Hamid, Rashid Saeed, Nusrat Ali.
Comparison of Two Techniques of Interlocking Intramedullary Nailing in Fractures of Tibia.
Pak J Med Health Sci Jan ;7(1):231-5.

Objective: To compare the results of reamed and unreamed interlocking intramedullary nailing in fractures of tibia in terms of their advantages and disadvantages, fracture stabilization, maintenance of alignment, complications and functional outcome. Design: Comparative prospective study Place and Duration: The study was carried out at the Department of Orthopaedic Surgery, Jinnah Hospital, Lahore between March 2012 to December 2012. Patients and methods: A total of 40 patients having closed or grade1 open fractures of tibia that presented within 12 hours of injury were admitted through emergency department. The detailed history was taken. The patients were evaluated both clinically and radiologically. Complete physical and systemic examination was performed to rule out associated injuries. The laboratory investigations were carried out and surgery was planned. Long leg splint was applied. By random selection Unreamed interlocking intramedullary nailing was performed in one group of 20 patients and in the 2nd group intramedullary interlocking nailing was done after reaming of the medullary cavity. Patients were informed about the nature, cost, advantages and limitations of the procedure. Results: The patients treated by the unreamed method of interlocking intramedullary nailing had better results regarding the rehabilitation, functional outcome, as scored by the evaluation criteria and radiological union time in comparison with the reamed method of interlocking intramedullary nailing which in relation to patients rehabilitation, functional outcome residual deformities, and post operative complications, scored less. There were no cases of nonunion resulting from either technique. Two patients developed superficial wound infection, both treated by the reamed method of intramedullary nailing but none developed chronic osteomyelitis. Conclusion: Unreamed interlocking nailing in tibial shaft fractures is a better option as it is associated with less complications, better rehabilitation, less incidences of developing residual deformities and thus better functional outcome.

PakMediNet -Pakistan's largest Database of Pakistani Medical Journals - http://www.pakmedinet.com