Tibial shaft fractures complicated by compartment syndrome: treatment with immediate fasciotomy and locked unreamed nailing.

Ten patients with an acute tibial shaft fracture complicated by a compartment syndrome were treated with immediate decompressive fasciotomies, bony stabilization with a locked unreamed intramedullary nail, and early active joint motion. There were seven closed and three open injuries. All fractures healed. Knee motion was excellent, but ankle and subtalar motion were not uniformly normal. Nine patients were without any long-term neurologic sequelae. This treatment protocol simplifies the bony and soft tissue management in patients with this combination of injuries.