The results of closed intramedullary nailing technique are excellent for treating fractures of the tibial shaft. Court Brown reported that the time to union and infection rates were similar when open tibial fractures were treated by reamed locked intramedullary nail or an external fixator. But references regarding the results, incidence of infection, nonunion related to the specific type of open injuryare limited. Hence we decided to analyse primary interlocking nailing for open tibial fractures.
Materials & Methods: All patients with open tibial fractures treated with primary interlocking nail were evaluated. Wound debridement and nailing were performed with image intensifier guidance. Static or dynamic locking was done depending upon the fracture stability.
Results: 44 patients with 44 fractures were included in the study. 15 (34%) type I, 19 (43%) type II, 9 (20%) type IIIA, 1 type IIIB open fractures were treated. Reaming was done in 41 (93%) patients. Nine (20%) of the nails were dynamically locked. 95% united uneventfully except two (5%). The average time to union was 26 weeks for type I fractures, 29 weeks for type II, 34 weeks for type IIIA, 38 weeks for the type IIIB. There were three deep infections (7%).
Conclusions: Primary Interlocking nailing for tibial open fractures is an excellent mode of therapy. Interlocking nailing reduces the incidence of complications like infection (7%), nonunion (5%). It is more acceptable to patients than external fixators.