Fractures of the tibia treated with Lottes nail fixation.

We have reviewed 60 consecutive cases, occurring in 57 patients, of intramedullary fixation of fractures of the midshaft of the tibia done over a ten-year period with the Lottes nail. Of 50 acute fractures, 38 were open fractures, nailed after adequate irrigation and debridement; the other 12 were closed fractures. The remaining ten cases were nonunions. All fractures healed with a rate of infection of 3.33% and a rate of malunion of 3.33%. Of the 50 patients with acute fracture, 29 had other fractures of long bones and 12 had ipsilateral fractures of the femur. The nailing facilitated their ambulation and care. All ten nonunions healed after nailing and bone grafting. Lottes nailing of tibial midshaft fractures is a simple procedure that gives stability, allows early weight-bearing with minimal shortening, and can be used in open fractures with minimal morbidity after adequate debridement.