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Orthopaedic Proceedings
Vol. 86-B, Issue SUPP_II | Pages 183 - 183
1 Feb 2004
Drosos GI Kayias E Stavropoulos NI Kouzoumpasis P Hatzopoulos ET
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Aim: The results of open tibial shaft fractures treated with reamed intramedullary nailing are presented. The same nail and protocol of treatent was used in all patients.

Patients and Methods: Twenty patients (mean age 25.2 years, s.d.: 6.0) with open tibial shaft fracture. The fractures were classified according to Gustillo classification (grade-I: 7, grade-II: 6, grade-IIIA: 7), and the comminution according to Winquist-Hansen classification (stable: 7, unstable: 13). All patients were treated within 6 hours from the injury, the wound was left open, followed by wound inspection and re-debridement (if needed) after 48 hours. A delayed primary suture or wound coverage was applied within 4–6 days.

Results: Eighteen fractures united with no need for additional operation. Non-union developed in 2 grade IIIA fractures (1 fracture healed after exchange nailing, and 1 fracture required an alternative method of treatment. The mean union time was 22.7 weeks (grade I: 20.2 weeks, grade II: 20.3 weeks, grade IIIA: 26.3 weeks). There was no infection. Dynamisation was applied in 7 fractures.

Conclusion: The results in this small series of open tibial shaft fractures treated with reamed intramedullary nailing are satisfactory and in accordance with the results of large larger-scale studies published (the recent years) recently in the literature.