Three years of experience with the clos nail for tibial shaft fractures

The Clos tibial nail is a new interlocking dynamic compression nail. From September 1998 to September 2001 fifty-six patients who had tibial shaft fractures were treated. Depending on positioning of the blocking screw, the system can be mounted in four different configurations: static configuration (19 cases), dynamic configuration (30 cases), static-compression configuration (1 case), and dynamic-compression configuration (6 cases). There were 40 male and 16 female (average age of 42 years); 36 simple fractures and 20 multifragmentary fractures. The fibula was safe in two cases, fractured at the same level of the tibial fracture in 34 cases and fractured at another level in 20 cases. The mean time to full weight bearing was 11 weeks (10-14). There were no cases of delayed union or dynamization or infections. All the fractures healed in a mean time of 16 weeks (10-20 weeks). There were 3 malunions, one in varus and two in valgus, and one patient healed with 3 cm of shortening. All patients returned to their previous activity levels.