Of fifty consecutive open fractures of the mid-part of the shaft of the
tibia that were treated from 1975 to 1980 with immediate intramedullary
Lottes-nail fixation and with debridement and irrigation, with minimum
periosteal disruption, all but one healed. The rate of infection was 6 per
cent; of delayed union, 16 per cent; and of malunion, 4 per cent. One
fracture, with arterial injury, resulted in amputation. The wounds were
classified as Gustilo and Anderson Type I (24 per cent), II (12 per cent),
or III (64 per cent). Seventy-six per cent of the patients had other
fractures, and 38 per cent had a fracture of the ipsilateral femur.
Sixty-four per cent of the fractures were segmental and 36 per cent were
transverse with comminution.