Unreamed Interlocking Intramedullary Nailing of a Grade II Open Tibial Shaft Fracture

A patient presented with a comminuted Grade II open tibial shaft fracture associated with a 1.5–2-cm wound. Unreamed interlocking intramedullary nailing was selected to provide stable fixation while limiting further disruption of the endosteal blood supply and potential contamination of the medullary canal.

1. The procedure was performed without a tourniquet
2. After measuring the canal
3. Two proximal locking screws were inserted
4. Protected partial weight-bearing with walker support was planned