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Abstract
Seventy tibial shaft fractures treated by intramedullary nailing using two different
techniques were compared. The first group (35 cases) was treated with a Herzog intramedullary
nail following hand reaming and minimal traction. The second group (35 cases) had
a Grosse and Kempf or AO nail inserted following power reaming and skeletal traction.
Fracture patterns were similar in both groups. In the hand-reamed group, the mean
time to union was 15.2 weeks with two delayed unions and no non-unions. In the power-reamed
group, the mean time to union was 19.9 weeks with 10 delayed unions and two non-unions.
These differences were statistically significant. Complications in the hand-reamed
group included a Sudecks atrophy and one mal-union. In the power-reamed group, there
were three transient foot drops, two compartment syndromes and one pulmonary embolus.
This difference was not statistically significant. Our findings suggest that surgical
technique has an important effect on the healing rates of nailed tibial shaft fractures.
When intramedullary nailing is performed, minimal reaming is required and skeletal
traction should be avoided if possible.
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Article info
Publication history
Accepted:
May 10,
1994
Identification
Copyright
© 1994 Published by Elsevier Inc.
