Bone and Joint Institute

Document Type

Conference Proceeding

Publication Date



Journal of Orthopaedic Trauma





First Page


Last Page


URL with Digital Object Identifier



© Copyright 2015 Wolters Kluwer Health, Inc. All rights reserved. Objectives: We sought to determine the effect of reaming on 1-year 36-item short-form general health survey (SF-36) and short musculoskeletal function assessment (SMFA) scores from the Study to Prospectively Evaluate Reamed Intramedullary Nails in patients with Tibial Fractures. Design: Prospective randomized controlled trial.1319 patients were randomized to reamed or unreamed nails. Fractures were categorized as open or closed. Setting: Twenty-nine academic and community health centers across the US, Canada, and the Netherlands. Patients/Participants: One thousand three hundred and nineteen skeletally mature patients with closed and open diaphyseal tibia fractures. Intervention: Reamed versus unreamed tibial nails. Main Outcome Measurements: SF-36 and the SMFA. Outcomes were obtained during the initial hospitalization to reflect preinjury status, and again at the 2-week, 3-month, 6-month, and 1-year follow-up. Repeated measures analyses were performed with P < 0.05 considered significant. Results: There were no differences between the reamed and unreamed groups at 12 months for either the SF-36 physical component score [42.9 vs. 43.4, P 0.54, 95% Confidence Interval for the difference (CI) -2.1 to 1.1] or the SMFA dysfunction index (18.0 vs. 17.6, P 0.79. 95% CI, -2.2 to 2.9). At one year, functional outcomes were significantly below baseline for the SF-36 physical componentf score, SMFA dysfunction index, and SMFA bothersome index (P < 0.001). Time and fracture type were significantly associated with functional outcome. Conclusions: Reaming does not affect functional outcomes after intramedullary nailing for tibial shaft fractures. Patients with open fractures have worse functional outcomes than those with a closed injury. Patients do not reach their baseline function by 1 year after surgery.


This is an author accepted manuscript.

Published in final edited form as: Lin. C. A., Swiontkowski, M., Bhandari, M., Walter, S. D., Schemitsch, E. H., Sanders, D., & Tornetta P. (2016). Reaming Does Not Affect Functional Outcomes after Open and Closed Tibial Shaft Fractures: The Results of a Randomized Controlled Trial. J Orthop Trauma, 30 (3): 142–148. doi:10.1097/BOT.0000000000000497

Note that erratum was published for this article.

Find in your library



To view the content in your browser, please download Adobe Reader or, alternately,
you may Download the file to your hard drive.

NOTE: The latest versions of Adobe Reader do not support viewing PDF files within Firefox on Mac OS and if you are using a modern (Intel) Mac, there is no official plugin for viewing PDF files within the browser window.