Introduction: The Expert Tibia Nail was designed to address proximal, shaft, segmental and distal tibia fractures in one implant. Multiple locking options in various directions provide more stability and reduce the risk of secondary malalignment. Angle stable cancellous bone locking screws in the tibia head also improve fixation.

We evaluated this new implant in our series in a prospective, multicenter setting.

Methods: 190 patients were treated in 10 participating centers using the Expert Tibia Nail (Synthes). 127 patients suffered polytrauma, 58 presented as open fractures. Within the framework of the study 5 cases were proximal tibia fractures, 108 shaft fractures, 56 distal fractures, and 21 segmental fractures. These were followed-up postoperatively, after 3 months and one year and evaluated radiologically and clinically with regard to malalignment, union rate and complications.

Results: Non union occurred in 9 cases after one year of follow up (n=150). 20 patients showed delayed union. The rate of open and complex fractures was high in this group. Dynamisation was performed in 10 cases. Valgus/varus and recurvatum/antecurvatum malalignment of more than 5 degrees occurred in 13 cases. Stable reduction was achieved in 144 cases. In 4 complex fractures, initial reduction went into malalignment. 2 patients developed a deep infection after 3rd degree open fractures. 34 patients suffered from pain in the operated area. 6 screws broke during the follow-up.

Discussion: The Expert Tibia Nail proved to be an excellent tool to treat tibia fractures. Not only shaft fractures but also complex fractures in the proximal and distal metaphyseal area can be successfully stabilized due to advanced locking options and design of the nail. The rate of malalignment, non-union and complications was low.