Unreamed Interlocking Intramedullary nailing of open Tibial Shaft Fracture Initially Treated with External Fixation

Suh, Jeung Tak; Park, Byung Guk; Yoo, Chong Il

Abstract

PURPOSE
To evaluate the treatment results, of open tibial shaft fracture assess its benefit and investigate ways to prevent deep infection or osteomyelitis.
MATERIALS AND METHODS
Thirty-one cases of open tibial shaft fracture treated by primary external fixation and secondary unreamed interlocking intramedullary nailing were investigated and evaluated in terms of items such as fracture location, pattern, bony union, complications, etc.
RESULTS
The most common cause was traffic accidents (23 cases, 74.2%), location was mid 1/3 (21 cases, 67.7%), pattern was comminuted one (16 cases, 51.6%) and open type was IIIb (14 cases, 45.1%). Duration of external fixation was 7.6 weeks in average, time interval to nailing after removal of external fixator was 15.7 days in average. Bony union was achieved within an average of 39.2 weeks after external fixation. Complications were 3 cases (9.7%) of delayed union, 5 cases (16.1%) of pin site infection, 1 case (3.2%) of deep infection, 2 cases (6.5%) of malunion and 2 cases (6.5%) of ankle stiffness. But nonunion and chronic osteomyelitis did not occur.
CONCLUSION
This method enables early soft tissue reconstruction and minimizes delayed union and nonunion in the severely contaminated or injured open tibial shaft fracture. The timing of secondary nailing should be established under exact principle in order to prevent very serious complications such as deep infection and osteomyelitis.