CLOSED TIBIAL FRACTURE - REAMED OR UNREAM ED NAILING - A CLINICAL-STUDY

When comparing the unreamed tibial nail (UTN) with the external fixato r in the treatment of open tibial fractures the UTN has shown advantag es. Wether we can find these advantages also in the treatment of close d tibial fractures using the UTN instead of a reamed system should be clarified in the following study. We compared 35 UTN treated patients with 35 patients that were treated with a reamed A0-universal tibial n ail. Both groups showed no differences in age, sex, etiology and sever ity of trauma. The fractures were classified by the A0-classification of fractures and the soft tissue damage by the classification of Tsche rne and Oestern. The length of mean hospital stay, the time of partial weight bearing and the duration of fracture healing, were shorter usi ng the UTN. 5 of 9 complications using the UTN were immanent to the sy stem (deformation of the locking screws). The other complications were 2 axis shifts, 1 compartment syndrome and 1 pseudarthrosis. The other group showed 1 hematoma, 1 axis shift, 1 compartment syndrome, 2 thro mboembolic complications, 2 infections and 3 cases of pseudarthrosis. We think that there is an advantage to use an UTN instead of a reamed nailing system in treatment of closed tibial fractures.