2007, Number 4
Acta Ortop Mex 2007; 21 (4)
García JJD, Aguilera ZJM, Tohen BA, Encalada DMI, Dávila SO
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ABSTRACTIntroduction: Tibial shaft fractures are common since they account for 9% of all fractures. Intramedullary nailing is described in the literature as the gold standard for their treatment and the most recent research emphasizes minimum exposure. Objective: To present the clinical and radiological course of closed, unreamed intramedullary fixation for tibial shaft fractures in a group of patients seen at Medica Sur Hospital. Material and methods: Twenty-two male patients with a diagnosis of tibial shaft fracture were analyzed retrospectively; mean age was 28 years. In all of them the Orthofix nail was inserted through the patellar tendon, with a closed approach and without reaming the medullary cavity. Results: Twenty patients had closed fractures (90.90%) and 2 patients had open fractures (9.09%). The mean time to starting ambulation with protected weight bearing was two weeks in 18 patients (81.81%); with full weight bearing, six weeks in 13 patients (91%). The mean time to full weight bearing without crutches was 10 weeks in 21 patients (95.45%). Mean radiographic grade III-IV healing time was 16 weeks. Complications were: delayed union in two patients (9.09%), compartmental syndrome, in one patient (4.45%). Conclusion: The Orthofix interlocking intramedullary nail placed with a closed approach provides immediate stability due to the proximal and distal locking. Patient rehabilitation is quicker, with total mobility, providing an early stimulation for callus formation and the added benefit of sparing the endosteal blood supply.