A study designed to determine optimal ratio of intramedullary nail diameter to tibial canal diameter that leads to reliable and timely healing in tibial shaft fractures

Fractures of the leg bones are the most common long bone fracture. In an average population, there are about 26 tibial diaphyseal fractures per 100,000 population per year. 1 Men are more commonly affected than women, with the male incidence about 41 per 100,000 per year and the female incidence about 12 per 100,000 per year. The average age of patients sustaining a tibia shaft fractures is 37 years with men having an average age of 31 years and women 54 years.1 

The management of tibial diaphyseal fractures has always held a particular interest for orthopaedic surgeons.2 Fractures of the shaft of the tibia cannot be treated by following a simple set of rules. Most fractures of tibia will heal if treated by non-operative means — this fact is undeniable.3 

The shaft of tibia is subcutaneous throughout its length and may have a diminished blood supply, severe complications and major disability are common outcomes.4 Fractures of the tibia and fibula can range from completely undisplaced fractures with minimal soft tissue damage to traumatic amputations. The treatment modalities described for tibia and fibula fractures range from simple cast immobilization to complex surgical procedures4 

Operative treatment is indicated for most tibial fractures caused by high-energy trauma. These fractures usually are unstable, comminuted, and associated with varying degrees of soft-tissue trauma. Operative treatment allows early motion, provides soft-tissue access, and avoids complications associated with immobilization. The goals of treatment are to obtain a healed, well-aligned fracture; pain-free weight bearing; and functional range of motion of the knee and ankle joints.