Open tibial fractures: current orthopaedic management.

Treating the spectrum of bone and soft-tissue injuries that can accompany open fractures of the tibia requires experience and judgment. It appears that the non-reamed interlocking nail can safely and reproducibly stabilize most low-energy and selected high-energy open fractures of the leg. Severe open tibial fractures require a staged reconstructive protocol using external fixation as the method of bony stabilization. Differentiation between the requirements of individual injuries remains the key to successful treatment.