Intramedullary Nailing of Tibial Shaft Fractures

Abstract

Tibial shaft fractures are common injuries that most often result from high-energy mechanisms. These fractures are particularly likely to be open fractures; many of them are severe. Intramedullary nailing is an effective technique for treatment of most tibial shaft fractures, with restoration of alignment, immediate motion, early weight bearing, and good/excellent clinical outcomes. Most surgeons consider displaced or unstable tibial shaft fractures as surgical indications, while some recommend intramedullary nailing for all complete tibial shaft fractures, unless a specific contraindication is present. In this article, the author provides a step-by-step description and video presentation of his surgical technique, including indications and contraindications, pearls and pitfalls, postoperative care, rehabilitation protocols, and reported outcomes.

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