Clinical experience with unreamed locked nails for open tibial fractures.

Open fractures of the tibia remain a formidable injury. External fixation has been the mainstay of treatment for the more severe fractures. This treatment option, however, is not without significant complications. Of particular importance is the rate of infection once the fixator is converted to a reamed intramedullary nail in cases of delayed union or nonunion. A retrospective review of the records of 20 patients who underwent unreamed, interlocked, intramedullary nailing for tibial fracture has shown that unreamed tibial rodding offers an excellent alternative to external fixation for the management of Grades I and II open tibial fractures. Additionally, for Grade III open fractures, this serves as an excellent form of preliminary stabilization, allowing the soft-tissue injury to heal.