Role of Reamed and Unreamed Interlocking Intermedullary Nailing in the Management of Compound Fracture of Shaft Tibia

DOI: https://doi.org/10.47648/jmsr.2014.v2302.04

Ahmed Md. F1 , Rahman Md. M2 , Dipu K3 , Islam Md. N4

Abstract

Tibia is the commonest bones to sustain open injury because of subcutaneous position. Treatment of open fractures requires simultaneous management of both skeletal and soft tissue injury. Intramedullary nailing with reaming is generally considered to be contraindicated for open fractures tibia, because it damages the endosteal blood supply which will lead to non-union, deep infection. The study was done to compare the clinical and radiological results of intramedullary interlocking nailing of open fractures of the tibial shaft after reaming versus unreamed medullary canal. Open fractures of shaft of tibia treated with unreamed/reamed interlocking nailing gave excellent results. In present series, 19 fractures (95%) treated by unreamed and 19 (95%) fractures treated by reamed technique, united within 6 months of injury. Delay in union was noticed in one patient treated by unreamed technique who had segmental and extensive soft tissue injury and in reamed nailing there was one patient with deep infection, which was treated with antibiotic coated nail. Time to complete union was similar in both groups. Adequate debridement of wound and adequate soft tissue coverage is the key to minimize deep infection irrespective of whether the bone is reamed or not.

Keywords:


  1. Associate Professor (cc), Department of Orthopaedics

    Holy Family Red Crescent Medical College, Dhaka

  2. Assistant Registrar, Department of Orthopaedics

    Holy Family Red Crescent Medical College, Dhaka

  3. Senior Medical Officer, Department of Orthopaedics

    Holy Family Red Crescent Medical College, Dhaka

  4. Associate Professor (cc), Department of Orthopaedics

    Holy Family Red Crescent Medical College, Dhaka


Volume 23, Number 2 July 2014
Page: 21-26