Background:  Tibial fractures were the most common long bone fracture. Closed intramedulary nailing is the treatment of choice in stabilizing displaced diaphyseal fractures of tibia but treatment by reamed versus unreamed intramedullary nailing was still controversial.

Purpose: The aim of the study was to assess relative merits of reamed and unreamed interlocking nails for tibial shaft fractures.

Methods :  40 patients with tibial shaft fractures who satisfy the inclusion criteria were selected. Among the selected, 22 patients were treated with reamed interlocking nailing and 18 patients treated with unreamed interlocking nailing. During the study period we did not lose any patient to follow up and results of all the 40 patients were assessed and analysed.

Results: The unreamed group demonstrated a significant higher rate of nonunion, higher incidence of implant exchange and screw breakage. Malunion was high in unreamed group but not statistically significant. The operating time was almost the same for both reamed and unreamed nails. Regarding the adverse effects like infection, compartment syndrome, and knee pain there was no significant difference between two groups.

Conclusion :  From this sample study, we conclude that reamed interlocking nailing have a better edge over unreamed interlocking nailing in closed and open type 1 tibial diaphyseal fractures.