Are small-diameter intramedullary nails enough for treating simple diaphyseal tibial fractures? A comparative study between small versus large nails

Purpose: The aim of our study was to compare the results of using small-diameter versus large-diameter interlocking reamed intramedullary nails in treatment of simple tibial shaft fractures. Methods: This prospective randomized control trial involved 60 patients, divided into two groups, Group A (Small IMN) (10 mm in males and 9 mm in females) and Group B (Large IMN) (12 mm in males and 11 mm in females). All patients were followed up for at least 1 year. Results: The mean operative time in Group A was 79 min versus 94.6 min in Group B. The mean time of radiological exposure in Group A was 2.27 min compared to 3.73 min in Group B. The mean union time in Group A was 15.2 weeks, while in Group B, the mean union time was 12.8 weeks. Implant failure (screw breakage or nail breakage) or nonunion did not occur in any case in the two groups. Conclusion: Small IMN showed comparable clinical and radiological results to large IMN with lesser operative and radioscopic time. We can recommend that small IMN should be used more often in treating simple stable tibial fractures.