Ravindra B. Gunaki1, Vilas S. Mane2, Himanshu G. Kulkarni3, Jeetendra Kataria4, Rupesh Gor5,Ketan Gupta6, Nirav Patel7
INTRODUCTION: Whether to ream the compound tibia fractures witle intramedullary interlocking nailing or not has been an eternal debate. So we have conducted a study to compare the functional outcomes, rate of infection and time needed for union in reamed and unreamed interlocking nailing on open tibia fractures.
METHODOLOGY: This study was carried out as a prospective, comparative study. 100 patients with open fractures of tibial shaft admitted in our hospital between June 2011 and January 2013 were enrolled in the study. Patients outside the age group of 20-50years of age, severely ommuniated fractures and fractures classified under Gustilo Anderson type IIIb and IIIc were excluded. 100 fractures were divided into two groups (reamed nailing and unreamed nailing) n=50 in each with simple randomization technique. Evaluation in the form of radiological union was done with serial x-rays and functional grading according to Klemm & Borner’s criteria for tibial shaft fractures was done at the end of 6 months.
RESULTS: Average fracture healing time was 16-20 weeks in both in undreamed nailing radiologically. Also, differences in rates of clinical union, clinical outcome, time for weight bearing and complication in both groups were not significant. Post-operative infection was found in 5 cases in reamed group and 3 cases in unreamed group.
CONCLUSION: There are no clear indications or contraindications or advantage/disadvantage to favour either reamed or unreamed nailing over each other. Fracture union, functional outcome and rate of complications are similar in both groups.
