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Thirty-four tibiae have been fixed by means of nested U-nails of which twenty-six have been followed from one to four years. There was rapid union of the tibia in all cases.Displacement or resection of a piece of the fibula is an essential part of this procedure, in spite of the fact that non-union of the fibula may occur.External fixation is used only if the fracture is in the proximal third of the tibia.All patients bore weight on the affected limb within one week of reduction except two with compound comminuted fractures.Intramedullary fixation is technically more difficult in the tibia than in the femur but otherwise quite as satisfactory.

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