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Nailing represents a particularly firm method of internal fixation for tibial fractures,
allowing rapid resumption of weight-bearing. The avoidance of opening the fracture
has many advantages—quicker union and much diminished risk of sepsis. The authors
describe their technique of closed nailing without reaming. They have reviewed 356
cases; 207 were closed fractures of which 200 had good results. One hundred and forty-nine
open fractures had 136 good results. One solitary case was amputated because of vascular
complications. The infection rate was nil in closed fractures and 8·1 per cent in
open fractures. All the infected cases healed secondarily after one or more operations.
A solitary case of malunion has been encountered.
The main indications for nailing are fractures of the lower third that are unstable,
oblique, or short spiral or with a butterfly fragment; segmental fractures; fractures
of the tibia associated with other injuries of the lower limb. Finally, indications
for nailing could be extended to lower fractures, even to those 5 cm. from the ankle-joint.
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References
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© 1970 Published by Elsevier Inc.
