We report the postoperative outcomes following the treatment of open tibial shaft fractures including Gustilo type IIIa fractures, with primary fixation using an unreamed intramedullary nail within the goledn hour.
11 fractures that were treated primarily with intramedullary nails with more than 6 months follow-up were studied. the average patient age at injury was 30.7 years (range: 14 to 55 years). There were 10 males and 1 female. The average follow-up was 9.8 months (range: 6 to 17 months). Fractures were classified as Gustilo type I: 2 cases, type II: 7 cases, type IIIa: 2 cases. AO classification showed type A: 4 cases, type B: 5 cases, and type C: 2 cases.
No complications were observed in all the patients. Callus showed clearly in 10 out of 11 cases after an average of 12.6 weeks (range: 6 to 19). The remaining case showed malunion but no other clinical complications.
We found that primary unreamed nailing is a safe and useful tretment for open tibial shaft fractures, as long as sufficient wound debridement is performed to prevent infection.