The effect of single-pass reaming on tibial nail insertion load and stress.

Abstract

This biomechanical study evaluated and compared the longitudinal and perpendicular stresses generated and the applied load required during the insertion of a tibial nail with three different insertion techniques. Insertion of a narrow-diameter nail using an unreamed technique generated significantly greater stress and required significantly greater applied load than either the single-pass reamed technique or a reamed technique. The single-pass reamed technique and the standard reamed technique were not significantly different from each other. This study biomechanically justifies the use of the single-pass reaming technique during the insertion of a narrow-diameter intramedullary nail in severe open tibial fractures. The use of this technique cannot be advocated until the biologic effect of single-pass reaming is more clearly defined.