Aim of this study: The aim of this prospective study was the evaluation of the results of intramedullary nailing with mild reaming for the treatment of closed tibial fractures.

Patients and Method: During the period 2001–2003 a total of 22 closed tibial fractures were managed. Fractures were classified according to the AO system. The method of treatment was determined by the degree of comminution at the fracture site as well as of the presence or not of intact fibula. Dynamic nailing was performed for the treatment of 9 fractures type A, static nailing following dynamization in 4–6 weeks with the presence of radiological callus formation was performed for the treatment of 5 fractures type B with > 50% comminution and dynamic nailing was performed for the treatment of 8 fractures type B with < 50% comminution. In 2 cases with intact fibula (A31, B21) osteotomy of the fibula performed at the same time. The mean size of the reaming was 11mm for the total of cases.

Results: The mean union time was 16 weeks, no infection or mechanical failure was recorded. Two cases of non-union were recorded (patient under anti-depression therapy and fracture type B23 in a patient with bilateral tibial fracture). Revision nailing were performed for these two cases (union in 14 and 16 weeks respectively).

Conclusion: Intramedullary nailing with limited reaming is a valuable method for the management of closed tibial fractures, especially in high energy fractures. Osteotomy of the tibia improves the mechanical environment at the fracture site.