Advances in tibial nailing

Abstract

Closed intramedullary nailing has become the "gold standard" in the treatment of displaced fractures of the tibial shaft [1, 3, 11, 12, 24, 26, 58, 59]. Intramedullary nailing has led to faster healing times and better fracture alignment than non-operative management [6]. Indications for the use of intramedullary nails have expanded in recent years to include treatment of metaphyseal fractures of the tibia, both proximally and at the extreme distal end [36]. Since very little "nail" effect occurs in the metaphyseal region due to diameter mismatch between the nail and the bone, surgical techniques and surgical implants have been revised to deal with these more troublesome fractures. Newer surgical implants allow for compression of appropriate fractures, which has certain advantages. In addition, some controversy still exists over reaming and nail size. © Springer Berlin Heidelberg 2006.