Ortho-Preferred

IM Nailing of Open Tibia Fractures



- See:
    - Open Tibia Fractures 
    - Infections of the Tibia 

    - " There have been major improvements in the surgical treatment of open tibial fractures during the past two decades. These improvements 
        include aggressive treatment of soft tissue injury by means of immediate debridement and early coverage as well as the preferred use of 
        IM nails instead of external fixation to stabilize the bony injury. These changes in the standard of care have been widely adopted with the 
        justified expectation of a lower rate of healing problems."
        - Recombinant human bone morphogenetic protein-2 for treatment of open tibial fractures: a prospective, controlled, randomized study of four hundred and fifty patients.

- Technical Considerations:
    - IM Nailing Technique:
    - reference:
          - Provisional Plating of Type III Open Tibia Fractures Prior to Intramedullary Nailing.



- References for Type III fractures: (see Gustillo classification)
    - Classification of type III (severe) open fractures relative to treatment and results.
    - Severe open fractures of the tibia
    - Severe open tibial fractures: a study protocol.
    - Complicated open fractures of the distal tibia treated by secondary interlocking nailing.
    - Reamed nailing of Gustilo grade-IIIB tibial fractures.
    - Emergency management of type IIIB open tibial fractures.
    - Unreamed rod with early wound closure for grade IIIA and IIIB open tibial fractures: analysis of 40 consecutive patients.
    - Treatment of type II, IIIA, and IIIB open frxs of the tibial shaft: a prospective comparison of unreamed interlocking IM nails and half-pin external fixators.
    - Superior results of tibial rodding versus external fixation in grade 3B fractures.
    - [Advantages of the unreamed tibial nail in comparison with external fixator in treatment of grade 3 B open tibial shaft fractures.]
    - Outcome of tibial shaft fractures with severe soft tissue injury treated by unreamed nailing versus external fixation.
    - Nonreamed interlocking nailing of closed tibial fractures with severe soft tissue injury.
    - Unreamed intramedullary nail versus external fixation in grade III open tibial fractures.
    - Treatment of grade-IIIb open tibial fractures. A prospective randomised comparison of external fixation and non-reamed locked nailing.
    - Unreamed interlocking nail versus external fixator for open type III tibia fractures.

- References for Reamed Nailing: (see reaming of tibia fractures)
    - Reamed interlocking intramedullary nailing of open fractures of the tibia. 
    - Locking intramedullary nailing with and without reaming for open fractures of the tibial shaft. A prospective, randomized study.
    - A prospective, randomized study of intramedullary nails inserted with and without reaming for the treatment of open and closed fractures of the tibial shaft.      

- References of Unreamed Nailing:
    - Rates and odds ratios for complications in closed and open tibial frxs treated with unreamed, small diameter tibial nails: a multicenter analysis of 467 cases.
    - Treatment of open fractures of the tibial shaft with the use of interlocking nailing without reaming.
    - The treatment of open tibial shaft fractures using an interlocked intramedullary nail without reaming.
    - Nonreamed locking intramedullary nailing for open fractures of the tibia.
    - Open tibial fractures: faster union after unreamed nailing than external fixation.
    - [Clinical results of primary intramedullary osteosynthesis with the unreamed AO/ASIF tibial intramedullary nail of open tibial shaft fractures.]
    - Outcome of tibial shaft fractures with severe soft tissue injury treated by unreamed nailing versus external fixation.
    - Nonreamed interlocking nailing of closed tibial fractures with severe soft tissue injury.
    - Unreamed intramedullary nail versus external fixation in grade III open tibial fractures.
    - Treatment of grade-IIIb open tibial fractures. A prospective randomised comparison of external fixation and non-reamed locked nailing.



Open tibial fractures with associated vascular injuries: prognosis for limb salvage.

Locked intramedullary nailing of open tibial fractures.

Local or free muscle flaps and unreamed interlocked nails for open tibial fractures.

Contaminated fractures of the tibia: a comparison of treatment modalities in an animal model.

Treatment of open fractures of the shaft of the tibia.



Original Text by Clifford R. Wheeless, III, MD.

Last updated by Data Trace Staff on Friday, August 3, 2012 10:16 am