Segmental tibial fractures treated with interlocking nails. A retrospective study of 33 cases

We treated 33 segmental tibial fractures with interlocking nails between 1986 and 1991. All fractures were managed with calcaneal traction, closed reduction, reaming and fixation with a Grosse-Kempf interlocking nail. The patients were followed for at least 15 months. The mean duration to union was 17 (12-20) weeks for the distal fractures and 20 (12-34) weeks for the proximal ones. There were only 3 cases of delayed union of the proximal fracture, 2 of which united after dynamization by removal of distal screws and 1 after autogenous bone grafting. There were 2 cases of deep infection, which were diagnosed after the fractures were united. The infection was treated with removal of the nail, reaming, and antibiotic treatment intravenously for 2 weeks and orally for 4 weeks. All patients returned to their previous activity level. We conclude that segmental tibial fractures can be treated with an interlocking nail and have a high rate of union and a low complication rate.