Primary unreamed and unlocked intramedullary nailing for open tibial fractures

ABSTRACT

Objective: The purpose of this study is to present our experience with the use of primary unreamed and unlocked nailing by the curved Kuntscher nail for open tibial fractures.Design: A retrospective study carried out between 1993 and 2003.Setting: Department of Orthopaedics Surgery; Yopougon Teaching Hospital; Abidjan; Coted'Ivoire.Patients and methods: A total of 154 open tibial shaft fractures in 149 patients were operated on by primary stabilisation with an unreamed and unlocked Kuntscher nail. Postoperatively; patients wore a leg plaster cast. Results: There were 124 men and 25 women with a mean age of 35 (16 to 72) years. Fractures werecaused in the majority of cases (130 cases; 87.2) by traffic accidents. Fractures were classified according to Cauchoix system into 96 grade I; 55 grade II; and 3 grade III. The duration of follow-up averaged nine (3 to 25) months. Infections (softtissue and bone) were encountered in 30 (19.5 ) fractures. 113 fractures (86.25 ) were primarily united with an average of 4.7 (two to six) months.Bone union was delayed for seven (5.3 ) fractures. Eleven (8.45 ) fractures developed nonunion. Malunion in valgus 10o was seen in three patients and in varus 10oin two. Rotational malalignment 10o was encountered in five patients