Similar central hemodynamics and oxygenation in reamed and unreamed intramedullary nailing of tibial fractures

Abstract

Background: Reamed intramedullary nailing of a long bone fracture is considered to be of crucial importance in the genesis of pulmonary disturbances. Use of unreamed nailing technique has been encouraged to avoid temporary deterioration in lung functions.

Methods: Central hemodynamic changes were recorded in 20 healthy adults with a unilateral simple tibial fracture undergoing reamed or unreamed intramedullary nailing. The patients were cannulated with a pulmonary artery catheter. Intramedullary nailing was performed during general anesthesia. Pre- and immediate postoperative hemodynamic variables were compared.

Results: Unchanged cardiac performance but pathologically altered pulmonary vascular tone were unrelated to the type of nailing technique. Increased oxygen consumption was observed as well.

Conclusion: Changes in cardiac and pulmonary hemodynamics are already present after the trauma and before the intramedullary nailing procedure.