O2431 ONE HUNDRED TIBIAL NONUNIONS TREATED WITH REAMED INTERLOCKING NAILING

Abstract

Aims: To investigate the effect of tibial reamed intramedullary nailing in treating tibial shaft aseptic nonunion. Method: Between 1990 to 2002, the intramedullary nailing was used in100 patients with aseptic tibial nonunion. Seventy-þve were men and 25 women with a mean age of 31 years (ranging from 18 to 76 years). Thirty-eight (38%) of the fractures were initially open (A:9, B:12, C:15) according to Gustilo-Anderson classiþcation. Sixty-seven (67%) cases were initially treated with external þxation, 13 (13%) with plate and screws, 6 (6%) with I.N., and 14 (14%)with plaster of Paris. The time that elapsed from injury to intramedullary nailing ranged from 6 months to 7 years (mean 15,6 months). Fibular osteotomy was performed in 76 cases through a separate incision. In 6 cases bone grafts from the iliac crest were used. Results: During a follow-up period of one to seven years (mean: 2 years), all of the cases achieved consolidation an average of 6 months after nailing. In 4 cases a late infection was observed which settled after nail removal. One patient developed impending compartment syndrome which was detected on the þrst post-operative day and was treated with a fasciotomy. Transient peroneal nerve palsy occurred in one patient and this recovered in 3 months. In nine patients a clinically acceptable deformity was noticed. Conclusions: Because of its high union rate and low complication rate, we believe that the reamed nailing technique should be considered preferentially for all aseptic tibial shaft nonunion cases.