We examined the correlation of bone mineral density and bone strength
in the cadaver tibia, and looked in vitro at the relative stability of
tibial fractures fixed with either reamed or unreamed tibial nails. B
one-mineral density correlated well with bone strength (r=0.946), but
paired tibias did not correlate closely. The unreamed nail-bone constr
uct was hss stable than the reamed construct in each pair tested P<0.0
5), and a comparison of all banes showed it to be less stable at all l
evels of our testing regimen, including failure (P<0.001). Bending and
breakage was seen in four of the smaller unreamed interlocking screws
(4 mm).