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The role of intramedullary nailing in treatment of open fractures

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European Journal of Trauma and Emergency Surgery Aims and scope Submit manuscript

Abstract

The management of open fractures remains one of the greatest challenges to orthopedic trauma surgeons. Damage to the soft tissue envelope together with periosteal stripping are the most important factors making open fractures prone to complications such as nonunion and infection. Urgent and thorough soft tissue debridement, proper surgical fracture stabilization as well as the administration of intravenous and local antibiotics as adjunctive therapy are mandatory to reduce the risk of infection. Intramedullary nail osteosynthesis has become an accepted treatment method of open long bone fractures. Especially at sites of sparse soft tissue coverage like the proximal and distal tibia, early intramedullary stabilization proved advantageous for its superior biomechanical stability, the chance of early soft tissue reconstruction, shorter healing times, and quicker rehabilitation. However, due to a potential risk of deep infection, especially when a reamed technique is applied, nailing of open fractures remains contentious. In this review, we focus on the current evidence of nail osteosynthesis in open fractures and delineate its value with respect to other possible treatment options.

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Conflict of interest

Alexander Hofmann, Sven-Oliver Dietz, Philip Pairon, and Pol M. Rommens declare that they have no conflict of interest.

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This article does not contain any studies with human or animal subjects performed by any of the authors.

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Authors and Affiliations

  1. Department of Orthopedics and Traumatology, University Medical Centre, Johannes Gutenberg-University Mainz, Langenbeckstr. 1, 55131, Mainz, Germany

    A. Hofmann, S.-O. Dietz, P. Pairon & P. M. Rommens

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  1. A. Hofmann
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  2. S.-O. Dietz
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  3. P. Pairon
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Correspondence to A. Hofmann.

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Hofmann, A., Dietz, SO., Pairon, P. et al. The role of intramedullary nailing in treatment of open fractures. Eur J Trauma Emerg Surg 41, 39–47 (2015). https://doi.org/10.1007/s00068-014-0485-5

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  • DOI: https://doi.org/10.1007/s00068-014-0485-5

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