Canine study using laser Doppler flowmetry to quantify how limited (7.0 mm) versus standard (9.0 mm) intramedullary reaming affects cortical bone perfusion at the time of locked tibial nailing and at eleven weeks, with biomechanical testing of the healed tibiae.
When nailing a tibial fracture in a patient with compromised vascularity — open injury with significant soft tissue loss, vascular injury, or a narrow medullary canal requiring a small-diameter nail — limit reaming to 7.0 mm rather than standard sequential reaming, as it preserves significantly more acute cortical perfusion without sacrificing long-term healing strength.
Canine study using laser Doppler flowmetry to quantify how limited (7.0 mm) versus standard (9.0 mm) intramedullary reaming affects cortical bone perfusion at the time of locked tibial nailing and at eleven weeks, with biomechanical testing of the healed tibiae.
When nailing a tibial fracture in a patient with compromised vascularity — open injury with significant soft tissue loss, vascular injury, or a narrow medullary canal requiring a small-diameter nail — limit reaming to 7.0 mm rather than standard sequential reaming, as it preserves significantly more acute cortical perfusion without sacrificing long-term healing strength.