Intramedullary nailing of tibial diaphyseal fractures in adolescents with open physes.

An analysis of 36 adolescent patients who presented with tibial diaphyseal fractures and open tibial physes has been undertaken. All patients were treated by reamed intramedullary nailing using a hollow, slotted nail. They were examined clinically and radiologically for late evidence of the effects of premature physeal closure secondary to nailing damage, but none were found. The speed of union in Tscherne C0 and C1 fractures in 13-16-year-old patients is highlighted and shown to be considerably faster than in adult patients. The speed of union in Tscherne C2 fractures is similar in adolescents and adults. The relatively high incidence of compartment syndrome in this age group is noted. Intramedullary nailing of tibial diaphyseal fractures in adolescents with open physes, using a slotted nail, appears to be safe and does not cause late growth problems.