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International Orthopaedics
Published in: International Orthopaedics 3/2004

01-06-2004 | Original Paper

Surgical Implant Generation Network (SIGN) intramedullary nailing of open fractures of the tibia

Authors: R. K. Shah, H. D. Moehring, R. P. Singh, A. Dhakal

Published in: International Orthopaedics | Issue 3/2004

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Abstract

We treated 36 open tibial fractures (32 patients) by primary intramedullary nailing and debridement and treatment of open wounds. There were 13 grade I, 14 grade II and 9 grade III according to Gustilo-Anderson classification. After a minimum follow-up of 8 months, there were two cases of superficial infection and one of deep infection. Thirty-one fractures united within 6 months with a mean period to union of 22 weeks. There were four delayed unions and one non-union. There was a longer union time and a higher rate of delayed or non-union in the complex and/or comminuted grade IIIB fractures. Intramedullary nailing, with appropriate soft-tissue treatment, gives good results in the treatment of open tibial fractures.
Literature
1.
Alberts KA, Loohagen G, Einarsdottir H (1999) Open tibial fractures: faster union after unreamed nailing than external fixation. Injury 30:519–23
2.
Bach AW, Hansen Jr ST (1989) Plates versus external fixation in severe open tibial shaft fractures: a randomized trial. Clin Orthop 241:89–94PubMed
3.
Bhandari M, Guyatt GH, Swiontkowski MF, Schemitscch EH (2001) Treatment of open fracture shaft of tibia: a systematic overview and metaanalysis. J Bone Joint Surg [Br] 83:62–68
4.
Bonatus T, Olson SA, Lee S, Chapman MW (1997) Non-reamed locking intramedullary nailing for open fractures of the tibia. Clin Orthop 339:58–64PubMed
5.
Court-Brown CM, McQueen MM, Quaba AA, Christie J (1991) Locked intramedullary nailing of open tibial fractures. J Bone Joint Surg [Br] 73:959–964
6.
Goldhahn S, Moser R, Bigler R, Matter P (2000) Treatment methods and outcomes of tibial shaft fractures in Switzerland. A prospective multicenter study of the Swiss AO.[Article in German], Swiss Surg 6:315–322
7.
Greitbauer M, Heinz T, Gaebler C, Stoik W, Vecsei V. (1998) Unreamed nailing of tibial fractures with the solid tibial nail. Clin Orthop 350:105–114CrossRefPubMed
8.
Gustilo RB, Anderson JT (1976) Prevention of infection in the treatment of one thousand and twenty-five open fractures of long bones: retrospective and prospective analyses. J Bone Joint Surg [Am] 58:453–458
9.
Hasenhuttl K (1981) The treatment of unstable fractures of the tibia and fibula with flexible medullary wires. A review of two hundred and thirty-five fractures. J Bone Joint Surg [Am] 63:921–931
10.
Henley MB, Chapman JR, Agel J, Harvey J, Whorton AM, Swiontkowski MF (1998) Treatment of type II, IIIA, and IIIB open fractures of tibial shaft. A prospective comparison of un-reamed interlocking intramedullary nails and half-pin external fixators. J Orthop Trauma 12:1–7CrossRefPubMed
11.
Holbrook JL, Swiontkowski MF, Sanders R (1989) Treatment of open fractures of the tibial shaft: ender nailing versus external fixation. A randomized prospective comparison. J Bone Joint Surg [Am] 71:1231–1238
12.
Ikem IC, Oginni LM, Bamgboye EA (2001) Open fractures of the lower limb in Nigeria, .Int Orthop 25:386–388CrossRefPubMed
13.
Klein MP, Rahn BA, Frigg R, Kessler S, Perren SM (1989) Reaming versus non-reaming in medullary nailing: interference with cortical circulation of the canine tibia. Arch Orthop Trauma Surg 109:314–316
14.
Klemm KW, Borner M (1986) Interlocking nailing of complex fractures of the femur and tibia. Clin Orthop 212:89–100PubMed
15.
Littenberg, B; Weinstein, L P et al (1998) Closed fractures of the tibial shaft, a meta-analysis of three methods of treatment, J Bone Joint Surg [Am] 80:174–183
16.
Lottes JO (1974) Medullary nailing of the tibia with triflange nail. Clin Orthop 105:53–66PubMed
17.
Melcher GA, Metzdorf A, Schegel U, Ziegler WJ, Perren SM, Printzen G (1995) Influence of reaming versus nonreaming in intramedullary nailing on local infection rate: experimental investigation in rabbits. J Trauma 39:1123–1128PubMed
18.
Melcher GA, Claudi B, Schlegel U, Perren SM, Printzen G, Munzinger J (1994) Influence of type of medullary nail on the development of local infection. An experimental study of solid and slotted nails in rabbits. J Bone Joint Surg [Br] 76:955–959
19.
Melcher GA, Ryf C, Leutenegger A, Ruedi T (1993) Tibial fractures treated with the AO unreamed tibial nail. Injury 24:407–410PubMed
20.
Schandelmaier P, Krettek C, Rudolf J, Kohl A, Katz BE, Tscherne H (1997) Superior results of tibial rodding versus external fixation in grade 3B fractures. Clin Orthop 342:164–172PubMed
21.
Stegemann P, Lorio M, Soriano R, Bone L (1995) Management protocol for unreamed interlocking tibial nails for open tibial fractures. J Orthop Trauma 9:117–120PubMed
22.
Toivanen JA, Honkonen SE, Koivisto AM, Jarvinen MJ (2001) Treatment of low-energy tibial shaft fractures: plaster cast compared with intramedullary nailing. Int Orthop 25:110–113CrossRefPubMed
23.
Tornetta P 3rd, Bergman M, Watnik N, Berlowitz G, Steuer J (1994) Treatment of grade-IIIb open tibial fractures. A prospective randomised comparison of external fixation and nonreamed locked nailing. J Bone Joint Surg [Br] 76:13–19
24.
Whittle AP, Russel TA, Taylor JC, Lavelle DG (1992). Treatment of open fractures of the tibial shaft with the use of interlocking nailing without reaming. J Bone Joint Surg [Am] 74:1162–1171
Metadata
Title
Surgical Implant Generation Network (SIGN) intramedullary nailing of open fractures of the tibia
Authors
R. K. Shah
H. D. Moehring
R. P. Singh
A. Dhakal
Publication date
01-06-2004
Publisher
Springer-Verlag
Published in
International Orthopaedics / Issue 3/2004
Print ISSN: 0341-2695
Electronic ISSN: 1432-5195
DOI
https://doi.org/10.1007/s00264-003-0535-9

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