الفهرس 
IntroductionOnly 14 pages are availabe for public view
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Abstract
This study demonstrates that grade I, II , III A and IIIB open tibial shaft fractures can be treated with primary debridement and locked reamed or un reamed intramedullary nailing with good short-term results, a better biomechanical stability and early rehabilitations and infection rates as compared to other methods.. from this study we can conclude that such technique of closed intramedullary nailing has many advantages and relatively less complications. Early mobilization ,early weight bearing ,lowest infection rate and acceptable union rate.we also conclude that sequential protocol for treating exposed tibial shaft fractures of Gustilo and Anderson Grade I, II and IIIA comprising initial treatment with thorough debridement, IV antibiotics and bony stabilization followed by osteosynthesis with intra medullary interlocking nailing, presented with high consolidation rates and low non-consolidation and infection rates.