Tibial Nailing - Steve Corbett 27/11/2001

INTRODUCTION

Important to remember that fractures may be different ie open / closed, proximal / middle / distal, comminuted etc, therefore must consider each fracture on its merits.
Considerable debate between reamed and non-reamed nails usage.
Debate centres on effects of type of nailing on healing, complications, blood flow, callus formation, free radical production etc.

PAPERS

Clinical - closed fractures

Authors

Court-Brown et al., (Edinburgh)

Title

Reamed or unreamed nailing for closed tibial fractures (Tscherne C1)

Reference

JBJS (Br) 1996; 78(4) : 580 -3

Summary

50 patients; prospective study; reamed GK nail v AO UTN nail; mean union reamed = 15 week v unreamed 22 week; 5 of unreamed group needed exchange nail; high malunion in unreamed due to implant failure especially locking screws (50%)

Critique

Numbers, bias, protocol including exclusion criteria and post weightbearing status may influence results



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