Outcome of Unreamed Tibia Interlocking Nail in Fractures of Shaft of Tibia in Adults: A Prospective Study

Abstract

Introduction: Tibial shaft fractures are prevalent long bone fractures in orthopedic practice, often accompanied by soft tissue injury, delayed union, and extended functional recovery. Intramedullary interlocking nailing has emerged as a recognized therapeutic method due to its ability to offer stable fixation while maintaining fracture biology. Unreamed tibial interlocking nailing may provide supplementary biological benefits by reducing endosteal vascular disturbance. This study assessed the clinical, radiological, and functional effects of unreamed tibial interlocking nailing in adult patients with tibial shaft fractures.

Methods: This prospective observational study was carried out in the Department of Orthopedics at GK General Hospital in Bhuj, Gujarat, India, from April 2024 to October 2025. Forty adult patients with tibial shaft fractures received treatment by unreamed tibial interlocking nails. Patients were monitored clinically and radiologically at regular intervals for up to six months. Fracture healing was measured utilizing the Radiographic Union Scale for Tibial Fractures (RUST).

Results:  Of the 40 patients, the predominant age group was 31–40 years (14/40, 35%), followed by 41–50 years (12/40, 30%). Male patients accounted for 31/40 (77.5%). Road traffic accidents were the mechanism of injury in 24/40 (60%) patients. Closed fractures occurred in 28/40 (70%), whereas open fractures occurred in 12/40 (30%). Radiological union was achieved in 17/40 (42.5%) patients between 13 and 16 weeks, and complete union within 16 weeks was observed in 30/40 (75%) patients. The average RUST score at three months was 9.55. The most prevalent postoperative consequence was anterior knee discomfort (10%), succeeded by infection (7.5%), delayed union (5%), hardware impingement (5%), and malunion (2.5%).

Conclusion: Unreamed tibial interlocking nailing shown adequate radiological healing and positive functional results in adult tibial shaft fractures. The preservation of fracture biology by stable fixation has led to acceptable complication rates and dependable clinical recovery, hence affirming its ongoing significance in the treatment of specific tibial shaft fractures.