Muhammad Akhtar, Abdullah Farooq Khan, Syed Faraz-ul Hassan Shah Gillani, Ahsan Farooq Khan.
Unreamed Tibial Nailing in Open Tibial Shaft Fractures.
Pak J Med Health Sci Jan ;12(4):1436-8.

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 85 consecutive patients with GA Type 3-A open tibial shaft fractures. Standard intramedullary nailing was done without reaming the medullary canal. Eighty patients were followed up to four years and four months and 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 8 5 participants there were 36 (42. 35%) male and 49 (57. 65%) were females. The mean age of the patients was 3 0.25+/-12.01 years (16 to 58 years). The primary union rate was 70% ( 56 patients). There were 15 (18.75 %) delayed union and 9(11.2 5%) non-union. The average time of union was 2 3.57+/-2.347 weeks (9- 28 weeks). Moreover, there were 9(11.25 %) superficial and 7(7.5%) deep infections. Three (3.7 5%) nail failure and four screw breakages. Conclusion: This study show ed a possible benefit of un-reamed intramedullary nailing for open 3A fracture of Tibia.

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