Open and closed tibial fractures

Summary

Evidence from one large and three smaller randomized controlled trials suggests that time to union may be faster and the proportion of patients with nonunion lower with the use of reamed compared with unreamed nails. The rate of complications appears to be similar between groups. Rates of reoperation were not statistically different between groups. Additional studies that measure patient function and quality of life could help substantiate these findings and provide more definitive evidence regarding advantages of reamed versus unreamed nailing of tibial fractures.