Tibial shaft fractures treated with the AO unreamed tibial nail.

ABSTRACT

BACKGROUND: The AO unreamed tibial nail (UTN) has been used for both open and closed tibial fractures. The reported results have been mixed. We evaluated its outcome in our unit. AIM: To assess the outcome of tibial shaft fractures treated with the AO UTN. METHODS: Forty-eight patients underwent intramedullary nailing between 1995 and 2000 using the AO UTN. Follow-up details were available for 45 patients. RESULTS: Forty-four fractures united (97%). Complications included one non-union (2.2%), 15 delayed unions (33%), nine had either broken or bent interlocking screws (20%), six malunions (13%) and three patients underwent fasciotomy for compartment syndrome (7%). Twenty-one patients underwent at least one additional operation to obtain union (47%). Of these, five underwent exchange nailing (11%). CONCLUSIONS: The AO UTN does have a high complication rate and, should it be used, we feel that early dynamisation or exchange nailing be considered to hasten union and prevent screw breakage.