Between November 1979 and January 1983, we treated fifty-one severe
fractures of the tibial shaft with multiple intramedullary Ender nails.
Thirty-six fractures were treated within two weeks after injury. Forty-one
fractures united in less than four months and eight, in four to eight
months. Only two were not united after eight months. An anatomical
reduction was maintained in all but three of the fractures, in which the
tibia shortened. Two tibiae united with an angulation of 7 degrees and one
with 6 degrees, as measured in two planes. There were two infections, both
after an open fracture. It has been our experience that Ender nails provide
excellent rotational stability, allow early full weight-bearing, and
markedly decrease the duration of need for immobilization. Ender nailing
was of value both for the acute management of complicated high-energy
fractures of the tibial shaft with extensive soft-tissue damage and as a
salvage procedure to maintain reduction of a fracture when other techniques
had failed.