Introduction: Intramedually nails, such as Lottes and Ender nails, used without reaming, have been employed successfully in the treatment of open tibial fractures and have been associated with low rates of post­operative infection. They are, however contraindicated for communited fractures, as there tends to be shortening or displacement of such fractures around these small nails. Methodology: Patients were operated under spinal / general anaesthesia. Patient is placed in supine position over a radiolucent operating table. The injured leg is positioned freely, with knee flexed 90o over the edge of operating table to relax the gastro soleus muscle and allow traction by gravity. The uninjured leg is placed in abduction, flexion and external rotation to ensure free movements of the image intensifier from A.P. to lateral plane. The table is adjusted to a comfortable operating height. Results: 21 cases (70%) had excellent results. 5 cases had good results (16.6%), 2 fair (6.7%) and two case (6.7%) poor result. Conclusion: Closed reamed interlocking intramedullary nailing with the help of image intensifier seems feasible in diaphyseal fractures of the tibia.

Keywords: Fracture Shaft Tibia; Intramedullary Interlocking Nail; Clinical Outcome.