Evaluation of Outcomes of Unreamed Interlocking Intramedullary Nailing in Open Tibial Shaft Fractures: An Observational Study (Code-T0298)

Introduction: Open tibial shaft fractures are common high-energy injuries that present significant challenges in orthopedic management. Unreamed interlocking intramedullary nailing (U-IMN) has emerged as an effective treatment option, preserving periosteal blood supply, minimizing infection risks, and facilitating early mobilization. Evaluating its clinical and functional outcomes is essential to establish its efficacy compared to other fixation techniques.

Aims and Objectives

Aim: To assess the clinical and radiological outcome of unreamed intramedullary interlocking nailing in open tibial shaft fracture and to compare functional outcome with the literature available.

Objective: To observe the clinical and functional outcome (infection, nonunion, mal union, implant failure, need for secondary operation) of unreamed nailing in patients with open tibial shaft fractures.

Methods: A prospective observational study was conducted at Adesh Medical College and Hospital, Shahabad, from July 2023 to September 2024. A total of 30 patients aged 18-60 years with open tibial shaft fractures (Gustilo-Anderson Grade I-III A) were included. Patients underwent U-IMN without reaming to preserve the endosteal blood supply. Postoperative outcomes were assessed using Klemm and Borner's criteria and Yokoyama’s modified evaluation. Statistical analysis was performed using SPSS v27, with chi-square and t-tests applied.

Results: The majority of fractures resulted from road traffic accidents (83%). Excellent functional outcomes were observed in 63% of patients, with 15% showing good results. The average fracture union time was 15 weeks for Grade IIIA and 18 weeks for Grade II fractures. Complications were minimal, with superficial infections in 10% of cases and delayed union in 7%. No deep infections or implant failures were reported.

Conclusion: Unreamed interlocking intramedullary nailing is an effective treatment modality for open tibial shaft fractures, offering excellent functional outcomes, reduced complication rates, and early mobilization. Further studies are recommended to assess long-term outcomes and compare efficacy with alternative fixation methods.

Keywords: Open Tibial Fracture, Intramedullary Nailing, Unreamed Nailing, Fracture Union, Functional Outcomes, Orthopedic Trauma