Fractures of the Tibia Treated with a Reamed Russell-Taylor Intramedullary Interlocking Nail

Abstract

Intramedullary locking nails are used as a treatment of choice in many cases of tibial shaft fractures. It represents a safe method of internal fixation with minimal blood loss and is less time consuming than other methods of internal fixation. The disadvantage of the method is the exposure in radiation of both the patient and the surgeon and his assistants (the C-Arm is used for the application of the distal locking bolts, with the free hand technique). The introduction of the radiation independent Distal Aiming Device (D.A.D.) seems to reduce the exposure in radiation and the duration of the operation. In a period of 9 years (March 1993 to March 2002), 118 patients were treated with this method. The Russell-Taylor Nail was used in all cases. Proximal screws were placed in all fractures while distal bolts were placed in 104/118 (88 %). In 76/118 fractures the free-hand technique was used while in the remaining 42 the D.A.D. was introduced. The time consumed for the assembly of the device did not affect at all the duration of the operation and the exposure in radiation was reduced considerably (2 instead of 30/34 shots with the free-hand technique). The average time for the union of the fracture was 4.5 months. There were no major complications or material failures.