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European Journal of Trauma and Emergency Surgery

Published in:

01-08-2014 | Original Article

Reamed versus unreamed nail in the treatment of tibia shaft fractures

Authors: J. Trlica, J. Kočí, P. Lochman, K. Šmejkal, M. Frank, T. Holeček, L. Hasenöhrlová, J. Zahradníček, J. Folvarský, I. Žvák, T. Dědek

Published in: European Journal of Trauma and Emergency Surgery | Issue 4/2014

Abstract

Purpose

The aim of the prospective randomized study was to compare the results of the treatment of tibia shaft fractures (TSF) by reamed or unreamed intramedullar nail.

Methods

There were 103 patients with 104 TSF enrolled in the study within the period from December 2005 to June 2010. Seven patients were excluded from the study. Factors of injury severity, course of surgery and hospitalization, and incidence of early and delayed complications were recorded. X-ray was performed every 4 weeks until the fracture was healed. Functional results were evaluated at least 1 year after the surgery. Closed fractures were classified according to Tscherne classification and the open ones according to Gustilo classification.

Results

Forty-eight patients with 49 TSF were treated by unreamed tibial nail. There were 15 women and 33 men in this group. Injury severity score (ISS) ranged from 4 to 25 (ø 6.63). There were 45 closed fractures (0 16; I 22; II 7) and four open fractures (I 2; II 1; IIIA 1). In the reamed nail group there were 48 TSF. ISS ranged from 4 to 18 (ø 6.13). There were 35 closed (0 17; I 13; II 5) and 13 open (I 5; II 5; IIIA 3) fractures in this group. The time of operation was on average 15 min shorter in the unreamed nail group. X-ray healing was the same in both groups (18.12 versus 17.92 weeks). We had four patients in the unreamed nail group and six patients in the reamed nail group with delayed healing (28–44 weeks). We recorded no infection, loss of reduction or re-operation in both groups. Follow-up of functional results was 90 %.

Conclusions

There was no statistically significant difference in clinical and functional results between the groups. We suggest that both methods are comparable.

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Title: Reamed versus unreamed nail in the treatment of tibia shaft fractures
Authors: J. Trlica
J. Kočí
P. Lochman
K. Šmejkal
M. Frank
T. Holeček
L. Hasenöhrlová
J. Zahradníček
J. Folvarský
I. Žvák
T. Dědek
Publication date: 01-08-2014
Publisher: Springer Berlin Heidelberg
Published in: European Journal of Trauma and Emergency Surgery / Issue 4/2014
Print ISSN: 1863-9933
Electronic ISSN: 1863-9941
DOI: https://doi.org/10.1007/s00068-013-0340-0

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Reamed versus unreamed nail in the treatment of tibia shaft fractures

Abstract

Purpose

Methods

Results

Conclusions

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