ArticleJournal of orthopaedic surgery and research2026
Clinical outcomes of intramedullary nailing for tibial shaft fractures caused by low-energy gunshot versus Gustilo-Anderson type I tibial shaft fractures.
Article in Journal of orthopaedic surgery and research, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundTibial shaft fractures caused by low-energy gunshot injuries represent a rare but challenging clinical problem. The optimal treatment approach, particularly in comparison with Gustilo-Anderson Type I open fractures, remains controversial.
methodsThis was a retrospective comparative study that included patients who underwent intramedullary nailing for tibial shaft fractures. Group 1 consisted of low-energy gunshot-induced fractures, while Group 2 included Gustilo-Anderson Type I open fractures. Demographic data, union time, Radiographic Union Score for Tibial Fractures (RUST), Johner-Wruhs functional classification, need for additional surgical intervention, and infection rates were compared.
resultsA total of 128 patients were included (68 in Group 1 and 60 in Group 2). No significant differences were observed between the groups regarding demographic characteristics, follow-up duration, union time, RUST scores, or Johner-Wruhs functional outcomes (p > 0.05). However, the infection rate was significantly higher in the low-energy gunshot group compared with the Gustilo-Anderson type I group (20.6% vs. 5.0%, p = 0.020).Nonunion and reoperation rates did not differ significantly between the groups.
conclusionIntramedullary nailing for tibial shaft fractures caused by low-energy gunshot injuries provides clinical and radiological outcomes comparable to those observed in Gustilo-Anderson type I open fractures. Nevertheless, these injuries appear to be associated with a higher risk of infection, warranting careful perioperative management and closer postoperative surveillance.
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