Unreamed nailing



Keywords: unreamed nailing
Description: Objective: To compare the outcome (union) between reamed and unreamed nailing in tibial diaphyseal fracture (transverse). Material and methods: This randomized study was carried out in the

Objective: To compare the outcome (union) between reamed and unreamed nailing in tibial diaphyseal fracture (transverse).

Material and methods: This randomized study was carried out in the Department of Orthopedic Surgery, Nishtar Hospital, Multan from January 2009 to September 2009. Two hundred and ten patients were divided into two groups A and B. Group A patients were managed by reamed interlocking tibial nail and group B patients by unreamed interlocking nail tibia. Follow up was done up to 3 months and outcome union was compared between both groups.

Conclusion: Our study suggests that there is no significant difference between reamed interlocking tibial nail and unreamed interlocking tibial nail. Although there is trend towards improved union with reamed interlocking nailing

Nicoll has stated, “Fractures of tibia are important for two reasons. The first is that they are common the second that they are controversial and anything that is both common and controversial must be important 1 ”. A long period of convalescence is inherent even to an uncomplicated healing course of notorious fracture 2. Both conservative and surgical techniques have been introduced in an effort to speed time to union while minimizing the occurrence of complications such as residual deformity, consolidation problems, refracture, infection, compartment syndrome, peripheral nerve injuries, anterior knee pain, joint stiffness and vascular complications.

Intramedullary locking nail has gained numerous advocates in the treatment of both closed and open tibial shaft fracture 3,4. This present study was undertaken to compare clinical and radiological outcome of interlocking nail with and without reaming.

This randomized study was carried out in the Department of Orthopaedic Surgery, Nishtar Hospital, Multan from January 2009 to September 2009. Two hundred and ten patients were divided into two groups A and B. Group A patients were managed by reamed interlocking tibial nail and group B patients by unreamed interlocking nail tibia. Follow up was done up to 3 months and outcome union was compared between both groups. Eligible patients fulfilling the inclusion criteria were recruited and they were explained about study procedure and purpose in brief and their informed consent was taken.

A total of 210 patients of tibial diaphyseal fracture were enrolled. The ages were ranged from 20 to 45 years, majority of patients fell in age group 30-45 years. Duration of fracture was 0-14 days. Out of 210 patients, 156 (86.7%) were male while 24 (13.3%) were female. So male to female ration is 6:61 (Table-1). Follow up of both groups were done at 3 months. Fifteen patients were dropped out from both groups. Patients who completed their follow up were included in analysis. After 3 months group-A patients were having union 80% while group-B were having 70% (p=0.121, chi square = 2.400).






Photogallery Unreamed nailing:


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