THE ROLE OF INTRAMEDULLARY NAILING IN MODERN TREATMENT OF OPEN FRACTURES OF THE TIBIA AND FEMUR

The increasing incidence of open tibial and femoral fractures causes g reat suffering by patients and is an enormous economic burden, necessi tating improved treatment. The current treatment of these fractures is reviewed, as well as the evolving role of intramedullary nailing in t his treatment. Intramedullary nailing seems to give better results tha n external fixation in Gustilo type I and II fractures, and is at leas t as good in type III, The introduction of the non-reamed interlocking intramedullary nail may bring about even better outcomes. Any improve ments in treatment should be based on thorough understanding of the bi ology and biomechanics of the injury,