Abstract
Background The AO unreamed tibial nail (UTN) has been used for both open and closed tibial fractures. The reported results have been mixed. We evaluated its outcome in our unit.
Aim To assess the outcome of tibial shaft fractures treated with the AO UTN.
Methods Forty-eight patients underwent intramedullary nailing between 1995 and 2000 using the AO UTN. Follow-up details were available for 45 patients.
Results Forty-four fractures united (97%). Complications included one non-union (2.2%), 15 delayed unions (33%), nine had either broken or bent interlocking screws (20%), six malunions (13%) and three patients underwent fasciotomy for compartment syndrome (7%). Twenty-one patients underwent at least one additional operation to obtain union (47%). Of these, five underwent exchange nailing (11%).
Conclusions The AO UTN does have a high complication rate and, should it be used, we feel that early dynamisation or exchange nailing be considered to hasten union and prevent screw breakage.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Klein KW, Borner M. Interlocking of complex fractures of the femur and tibia.Clin Orthop 1997; 338: 182–91.
Alho A, Ekeland A, Stromsoe K et al. Locked intramedullary nailing for displaced tibial shaft fractures.JBJS (Br) 1990; 72: 805–9.
Court- B rown CM, Christie J, McQueen MM. Closed intramedullary tibial nailing: its use in closed and open type I fractures.JBJS (Br) 1990; 72: 605–11.
Ekeland A, Thoresen BO, Alho A et al. Interlocking intramedullary nailing in the treatment of tibial fractures: a report of 45 cases.Clin Orthop 1988; 231: 205–15.
Trafton PG. Closed unstable fractures of the tibia.Clin Orthop 1988; 230: 58–67.
Woll TS, Duwelius PJ. The segmental fractures.Clin Orthop 1992; 281:204–7.
McQueen MM, Christie J, Court-Brown CM. Compartment pressures after intramedullary nailing of tibia.JBJS (Br) 1990; 72: 395–7.
Guidance document for the preparation of investigational device exemptions and pre-market approval applications for bone growth stimulator devices. Rockville, Maryland, United States Food & Drug Administration, 1988.
Court-Brown CM, Will E, Christie J et al. Reamed or unreamed nailing for closed tibial fractures.JBJS (Br) 1996; 78: 580–3.
Keating JF, O’Brien PI, Blachut PA et al. Reamed interlocking intramedullary nailing of open fractures of die tibia.Clin Orthop 1997; 338: 182–91.
Heim D, Regazzoni P, Tsakiris DA et al. Intramedullary nailing and pulmonary embolism: does unreamed nailing prevent embolism? An in vivo study in rabbits.J Trauma 1995; 38: 899–906.
Wozasek GE, Simon P, Redl H et al. Intramedullary pressure changes and fat intravasation during intramedullary nailing: an experimental study in sheep.J Trauma 1994; 36: 202–7.
Pratt DJ, Papagiannopoulos G, Rees PH, Quinnell R. The effects of intramedullary reaming on the torsional strength of the femur.Injury 1987; 18: 177–9.
Schemitch EH, Kowalski MJ, Swiontowski MF et al. Cortical bone blood flow in reamed and unreamed locked intramedullary nailing: a fracture tibia model in sheep.J Orthop Trauma 1994; 8: 373–82.
Lin J, Hou SM. Unreamed locked tight fitting nailing for acute tibial fractures.J Orthop Trauma 2001; 15: 40–6.
Haas N, Krettek C, Schandelmaier P et al. A new solid unreamed tibial nail for shaft fractures with severe soft tissue injury.Injury 1993; 38: 899–906.
Mulcahy DM, McElwain JP. Grosse Kempf reamed nailing of tibial fractures. J Ir Coll Phy & Surg 1995: 174–6.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Kutty, S., Farooq, M., Murphy, D. et al. Tibial shaft fractures treated with the AO unreamed tibial nail. Ir J Med Sci 172, 141–142 (2003). https://doi.org/10.1007/BF02914501
Issue Date:
DOI: https://doi.org/10.1007/BF02914501