Epidemiology and Outcomes of Intramedullary Nailing for Tibial Diaphyseal Fractures: A Retrospective Multicenter Cohort Study

BACKGROUND: Intramedullary nails (IMN) are frequently used to fix tibial diaphyseal fractures. Despite good outcomes, complications such as infections, malunion, and nonunion may still occur, especially in low- and middle-income countries where healthcare resources and trauma care systems are often limited. This retrospective multicenter cohort study aimed to evaluate the epidemiology and clinical outcomes of IMN in tibial diaphyseal fractures in Brazil in terms of consolidation and complications. MATERIALS AND METHODS: We analyzed data from 125 patients who underwent IMN for fixation of tibial diaphyseal fractures between August 2020 and January 2024 at two Brazilian hospitals. RESULTS: Traffic accidents were the most common injury mechanism (84%), and closed fractures accounted for 80.8% of the cases. Most patients (98.4%) achieved fracture consolidation within six months post-surgery, with a low complication rate (3.2%), including two nonunions with screw breakage, one malunion, and one infection. There was a significant association between previous external fixation and the type of fracture (closed and open). However, there was no significant association between previous external fixation and consolidation one year post-surgery. CONCLUSION: The findings suggest that IMN is effective in achieving consolidation and low complication rates in Brazilian hospitals.