Objective: To evaluate and present our experience using the expandable nail system for the treatment of tibial shaft fractures.

Design: Retrospective study.

Setting: Level 1 Trauma Center – University teaching hospital.

Methods: Fifty-nine consecutive patients treated by this nail system for tibia fracture, fifty-four were acute fractures and five non-unions that were not included in the study. Two nail diameters were used, 8.5mm and 10mm. Operation, hospitalization and healing times, reaming versus non-reaming, isolated versus multiple injuries and re-operations were recorded and analyzed statistically.

Results All fractures healed in an average time of 72 days. The average healing times for patients treated with an 8.5 mm and 10 mm nail were 77.2 days and 63.4 days respectively. Average operative time was 103 minutes if reamed and 56 minutes if unreamed. Average healing times were 65.4 if reamed and 79.5 days if unreamed. Hardware was removed in 6 patients, and one patient underwent exchange nailing due to a delayed union. Operative time was shorter in the motor-vehicle group, 74 minutes in comparison to 80 and 84 minutes for the fall and pedestrian group.

Conclusion: The expandable nail offers the theoretical advantages of improved load sharing and rotational control without the need for interlocking screws. This study demonstrates satisfactory healing and alignment for the treatment of tibial shaft fractures using this device.