Randomized Trial of Reamed and Unreamed Intramedullary Nailing of Tibial Shaft Fractures

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Abstract

Abstract A multicenter randomized controlled trial of 1226 patients with tibial shaft fractures was conducted across 29 centers in Canada, comparing reoperation and complication rates between reamed and unreamed intramedullary nailing. It showed that reoperation rates were lower in the reamed group for closed fractures. In open fractures, there was no significant difference between reamed and unreamed groups. The overall reoperation rate in this study was 4.6%. There were significantly more deaths in the reamed compared to the unreamed group; however, the deaths were unrelated to the intramedullary nailing procedure itself.