Infection Rate of Reamed versus Unreamed Intramedullary Nailing in Open Tibia Fractures

Background: Intramedullary nailing (IM nailing) is the standard of care for the treatment of most diaphyseal lower extremityfractures. A few studies have assessed and compared the infection rate following reamed and unreamed IM nailing in open longbone fractures. In the present study, we attempted to compare the infection rate between two procedures in open fractures of tibia.Methods: In this prospective study, we included consecutive patients suffering from open fractures of tibia (Gustilo subtypes II orIIIA) who required IM nailing. Patients younger than 16 years old, other Gustilo types (I, IIIB, and IIIC), fractures reaching to the tibialplateau articular surface, and simultaneous fractures of other bones in the extremity were excluded. All patients were followed upfor one year to assess the postoperative infection rate.Results: Of 59 patients, 37 underwent reamed IM nailing and 22 underwent unreamed IM nailing. In reamed group, 4 cases (10.8%)experienced an infection requiring reoperation and antibiotic therapy, while in the unreamed group, it was 5 cases (22.7%). Thedifference between the groups was not statistically significant.Conclusion: Reamed and unreamed IM nailing procedures for fractures of tibia have similar outcome regarding long-termpostoperative infections that require reoperation and antibiotic therapy.