Influence of Reaming versus Nonreaming in Intramedullary Nailing on Local Infection Rate

The question of whether the impairment of the endosteal blood supply, which is induced by nailing with reaming of the medullary cavity, increases the risk of a postoperative infection cannot be conclusively answered by studying existing literature. The aim of this study was to investigate the effect of medullary reaming on the occurrence of local infection based on an infection model in the rabbit tibia (n = 44). An infection rate of 50% was found after unreamed nailing, as opposed to an infection rate of 64% after medullary reaming. The number of bacteria observed after reaming was significantly higher than after nail insertion without previous reaming. The differing susceptibilities to infection as observed in this model are statistically significant (p < or = 0.05).