Fifty open fractures of the tibial shaft that were treated with
debridement and interlocking nailing without reaming were followed for an
average of twelve months. Most of the fractures were the result of
high-energy trauma, and 68 per cent of the fracture wounds were grade III.
Forty-eight (96 per cent) of the fifty fractures united at an average of
seven months; there were no malunions. There were four infections (8 per
cent), all at the sites of grade-III fractures. Locking screws broke in
five tibiae (10 per cent), but the breakage did not result in a loss of
reduction. Three nails broke, two at the sites of ununited fractures and
one at the site of a healed fracture. These results are comparable with, or
better than, those obtained with other forms of fixation, including
immobilization with a cast, unlocked intramedullary nailing, and external
fixation.