Tissue perfusion after intramedullary nailing of tibial shaft fracture

Backgrounds and Aims: To measure noninvasively the effect of circulative ch anges caused by fracture and intramedullary nailing on tibialis posterior ( TPA), dorsalis pedis (DPA) and sum (TPA+DPA) arterial peak signals, transcu taneus oxygen tension (PtcO2) as well as local skin temperature (T) in pati ents with tibial shaft fractures. Patients, Material and Methods: A total of thirty tibias consisting of ten closed, reamed, intramedullary nailed simple tibial shaft fractures (Type A O A), ten contralateral tibias and as controls, ten intact tibias of health y volunteers. The measurements took place one day before and immediately after nailing, s ix hours later and during five days postoperatively. The values were compar ed to those of contralateral legs and to control legs. Results: In the nailed legs the mean TPA and PtcO2 remained at a significan tly lower level compared to the contralateral legs throughout the study (p < 0.003 in both cases). However, the alterations in DPA and TPA+DPA were no t statistically significant. Additionally, skin temperature on the fracture site was averagely 3 degrees C warmer than that of the contralaterals (p < 0.001). All the measured parameters were statistically significantly highe r in control legs compared to contralateral legs. There were no statistical ly significant differences between pre-and postoperative values in any meas ured parameters. Conclusion: The changes in the local tissue perfusion variables measured in the present study reflect rather the injury mechanism itself than the effe ct of reaming and intramedullary nailing in simple tibial fractures. Additi onally, arterial circulation was reduced in the contralateral legs.