UNREAMED TIBIAL NAIL IN THE TREATMENT OF OPEN TIBIAL SHAFT FRACTURES

The recently developed unreamed tibial nail (UTN) offers a new possibi lity for biological osteosynthesis by intramedullary stabilization for tibial fractures including those with severe closed and open soft tis sue damage. In a retrospective study we compared the well established method of external fixation with unreamed intramedullary nailing for o pen tibial shaft fractures. The data of our first 15 cases treated pri marily by UTN (Group 1) and another 15 cases comparable in etiology, s everity of trauma, fracture classification, open soft tissue damage an d the rate for myocutaneous flaps and skin-grafts, treated initially b y external fixation (Group 2) were reviewed. Septic complications were only seen in group 2 and made necessary a lot of following additional operations. One angular deformity was seen in each group. Group 1 sho wed a mean hospital stay of 26.3 days compared to 75.7 days in group 2 . Full weight-bearing was achieved after 1.8 months (group 1) whereas it took 4.5 months in group 2. The first clinical experience using the UTN shows an obvious advantage in comparison to fracture management b y external fixation mainly due to a low complication rate and a much s horter over all surgical treatment period.