Malunion after intramedullary nailing of tibial shaft fractures.

The purpose of the study was to find out the consequences of malunion of tibial shaft fracture.Sixty-four fractures were treated using an intramedullary nail or an intramedullary compression nail. Malunion was defined as an angular or rotational deformity exceeding five degrees or a shortening exceeding 10 mm.The number of malunited fractures was 17. The main reason for malunion was a technical failure occurring in 11 fractures. Patients with malunion had on average twice as many pathological functional findings as patients with sound union (P < 0.05). The mean number of subjective complaints was 5.3 in the malunion group and 3.3 in the sound union group. Among patients less than 45 years of age, those with malunited fractures had to reduce or give up physical exercise more often than those with fractures with sound union (P < 0.05).Malunion of tibial shaft fracture seems to be especially harmful in distal fractures, in fractures with marked primary displacement, in fractures caused by high energy injury, and among patients less than 45 years of age.