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The Journal of Bone & Joint Surgery British Volume
Vol. 79-B, Issue 3 | Pages 433 - 437
1 May 1997
Antich-Adrover P Martí-Garin D Murias-Alvarez J Puente-Alonso C

We performed a prospective, randomised trial in 39 patients with open tibial fractures treated initially by external fixation to compare cast immobilisation (group A) and intramedullary nailing (group B) as a sequential protocol planned from the onset of treatment.

The results showed that group B achieved faster union (p < 0.05) than group A with less malunion or shortening and a greater range of movement. Patients treated by intramedullary nailing required fewer radiographs and outpatient visits (p = 0.0015) and had a more predictable and rapid return to full function.

We feel that these severe fractures are better treated by delayed intramedullary nailing and that this has an acceptable rate of complications.