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Reaming damages the medullary blood supply and causes temporary necrosis of the diaphyseal bone. Theoretically, this increases the risk of infection, particularly relevant for open fractures. However, clinical studies have not demonstrated that this is very significant.
The surgeon should consider whether or not the benefits of reaming are worth the associated risks when choosing whether or not to use reaming for tibial intramedullary nails.
The individual patient’s medullary canal size, as well as probable mechanical stresses, must be included in this consideration.