Evaluating the Outcomes of Unreamed Interlocking Intramedullary Nailing in Open Tibial Shaft Fractures: An Observational Study (code: T0003)

Introduction
Open tibial shaft fractures are among the most common high-energy orthopedic injuries, typically resulting from road traffic accidents. These fractures are particularly challenging to manage due to extensive soft tissue damage and a significant risk of infection, delayed union, non-union, and malunion. Unreamed interlocking intramedullary nailing has emerged as a preferred treatment approach, providing mechanical stability and facilitating early mobilization with reduced complication rates.

AIM & OBJECTIVE

AIM

To assess the clinical and radiological outcome of unreamed intramedullary interlocking nailing inopentibial 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
This observational, prospective study was conducted at Adesh Medical College and Hospital from August 2023 to October 2024. The study enrolled 50 patients aged 20–65 years with open tibial shaft fractures categorized as Gustilo-Anderson grades I to IIIB. After extensive wound debridement, fractures were stabilized with unreamed interlocking nails. Patients were evaluated for infection rates, union times, alignment issues (malunion), nonunion, and functional recovery. Functional outcomes were assessed using the Modified Klemm and Borner criteria, while statistical analysis was performed using SPSS version 28.

Results
Preliminary findings showed a high union rate, with 85% of fractures uniting within 20 weeks on average. Infection rates were recorded at 8%, while functional outcomes revealed that 70% of patients achieved excellent to good results. Factors influencing outcomes included the severity of the fracture and associated soft tissue injuries. Grade IIIB fractures demonstrated a prolonged union time and a higher incidence of complications.

Conclusion
Unreamed interlocking intramedullary nailing is an effective and reliable treatment option for managing open tibial shaft fractures. The technique offers stable fixation, early mobilization, and satisfactory functional outcomes, even in cases with severe fractures. These results underscore its relevance in managing complex fractures, particularly in high-trauma and resource-limited settings.