UNREAMED NAILING OF TIBIAL FRACTURES WITH THE SOLID TIBIAL NAIL

In 1993 a solid 7.5-mm tibial nail was developed and is composed of a wrought stainless steel alloy. In a preclinical testing series its sta tic and dynamic mechanical properties proved to be superior to other s mall diameter nails. The clinical application of the Solid Tibial Nail in 70 cases of acute tibial diaphyseal fractures showed promising res ults, Neither severe intraoperative complications nor infections were observed. The entire series, including seven Grade I, eight Grade II, four Grade IIIA, and nine Grade IIIB open fractures, revealed a union rate of 95% at 6 months postoperative. After dynamization in one case and reaming and renailing in three cases, the fractures with delayed h ealing progressed to union within the following 3 months. There was no need for bone grafting in any of the cases. Locking screw breakage wa s observed in 10 (14%) cases 8 to 24 weeks postoperatively, This did n ot lead to any additional complications. No nail failures were observe d. The excellent results of unreamed nailing with the Solid Tibial Nai l consequently led to its use as the primary method of treatment for t ibial fractures associated with soft tissue injury at the authors' ins titution.