Intramedullary fixation of tibial shaft fractures: a comparison of the unlocked and interlocked nail

Abstract

The study is a prospective evaluation and comparison. Eighty-two patients with tibial shaft fractures were treated with intramedullary fixation by either an unlocked nail (ULN) or an interlocked nail (ILN). All patients were followed up for 12 months with a functional score evaluation. The patients were divided into two groups, based on the method of treatment. The ULN group included 42 patients with an average age of 43.1 years. The ILN group included 40 patients with an average age of 40.0 years. Both groups were similar in the injury mechanism, fracture location, open fracture type and associated medical conditions (all P > 0.05). The operative time was shorter and the wound size smaller in the ULN group when compared to the ILN group (P < 0.001). The union rate, healing time and malunion rate were not significantly different between the two groups (P > 0.05). Although the functional score showed no difference between the groups (P = 0.3), the ILN group had a greater ability to return to their work 6 months after surgery (P = 0.03). In conclusion, unlocked nailing for tibial shaft fractures is a simple and effective method especially in the treatment of middle-third fractures. Interlocked nailing gives stable fixation without cast immobilisation, which resulted in a greater ability for the patients to return to their previous work 6 months after surgery.