Unreamed nailing of tibial fractures--a prospective study of the routine use of the unreamed tibial nail.

We prospectively studied 44 patients treated with the AO Unreamed Tibial Nail (UTN) at two orthopaedic trauma units. There were 15 open fractures: eight type I, four type II, one type IIIA, and two IIIB (Gustilo). The mean follow-up time was 13 months (range 6-24 months). There were 14 type A, 26 type B and four type C fractures (AO classification, Muller). All patients with the open fractures had surgery within eight hours of injury. Closed fractures were treated on the next available trauma list. The mean time to fracture union was 15.3 weeks (range 10-26). In the closed fracture group (n = 29), the mean time to union was 14.9 weeks compared to 18.6 weeks for the open fracture group. There were no non-unions and no infections. One patient had a malunion and breakage of locking bolts occurred in two cases. Our results indicate that the UTN provides excellent results in the treatment of both closed and open fractures of the tibial shaft, with union times comparable to reamed techniques.