Ender nailing of problem tibial shaft fractures

Twenty-seven patients with fractures of the shaft of the tibia, involving 15 closed and 12 open fractures, were treated by Ender intramedullary fixation from December 1978 through July 1981. All closed fractures required Ender nailing due to failure to obtain initial satisfactory closed reduction or failure to maintain adequate reduction after initial closed treatment. Following debridement, all grade I and grade II open fractures that did not meet criteria for satisfactory reduction by closed methods were treated with Ender nailing. Union occurred in 100% of grade I and grade II open fractures, and 93% of closed fractures. One failure of fixation, one delayed union, and one nonunion occurred.