Infection after reamed intramedullary nailing of lower limb fractures. A review of 1,464 cases over 15 years.

We studied 1,464 consecutive immediately-reamed intramedullary locked nailings of tibial or femoral fractures. There was an increase in postoperative infection if the tibial fracture was open; the relative risk increased with the severity of the soft tissue lesion. There was a marginal increase in the postoperative infection rate for open femoral fractures. A comparison of these figures with those in other methods of treatment and the mechanical and clinical advantages of nailing leads us to propose this method of treatment for Grades I and II open fractures of the femur or tibia.