THE EFFECT OF SINGLE-PASS REAMING ON TIBIAL NAIL INSERTION LOAD AND STRESS

This biomechanical study evaluated and compared the longitudinal and p erpendicular stresses generated and the applied load required during t he insertion of a tibial nail with three different insertion technique s. insertion of a narrow-diameter nail using an unreamed technique gen erated significantly greater stress and required significantly greater applied load than either the single-pass reamed technique or a reamed technique. The single-pass reamed technique and the standard reamed t echnique were not significantly different from each other. This study biomechanically justifies the use of the single-pass reaming technique during the insertion of a narrow-diameter intramedullary nail in seve re open tibial fractures. The use of this technique cannot be advocate d until the biologic effect of single-pass reaming is more clearly def ined.