Treatment of tibial malunions and nonunions with reamed intramedullary nails.

Reamed intramedullary nailing is an effective, relatively low-risk technique for the management of delayed union, nonunion, and malunion of the tibia. Closed technique should be used where possible and open realignment, when necessary, should be executed with minimal dissection. Bone grafting is rarely indicated. The use of interlocking nails provides an added degree of security in the control of rotation.