Unreamed Interlocking Nailing in Open Fractures of Tibia

Letter to the Editor Unreamed interlocking nailing in open fractures of tibiaDesigned as temporary implants, the unreamed nails can only bear a certain number of load cycles, significantly less than the locking screws of reamed nails.As a consequence, screw failure occurs frequently in unreamed nailing, especially on weight bearing.3 To hasten union and avoid screw failure, other studies have recommended early dynamisation or exchange nailing and bone grafting.2,4 Joshi et al. 1 used unreamed interlocking nails for several axially unstable and comminuted open tibial fractures.Nonetheless, screw breakage in their series was found only in cases with delayed union and non-union (8 cases).Bone grafting was also used scantly, only in cases where there was established delayed union and non-union.Furthermore, there was no mention of malunions, rotations, angulations, or shortening in the results despite high incidence in other series.[4][5][6] It would be helpful if the authors could detail the postoperative protocol and the method of supplementary protection used, if any, during mobilisation and ambulation.