The Interlocking Nailing System and Technique

  • Damien F. Gill
  • Fouzia Khatun
  • Wasim S. Khan


The advent of the interlocking nail has revolutionized surgical fracture fixation, with minimally invasive techniques that avoid further soft-tissue injury and preserve fracture biology. The continued evolution of designs has led to implants that are able to withstand axial loading, which allows for early mobilization and weight bearing. As the indications for intramedullary nailing have extended beyond the original scope of diaphyseal fractures, techniques have been developed to aid reduction and counter deforming forces. This natural progression of the humble interlocking nail has helped push it to the forefront of trauma management. Understanding of the biomechanical principles that underlie how interlocking nails work is crucial in being able to utilize the technique to the best effect. Here, we discuss the factors that influence how an interlocking nail works, the general principles of nailing techniques in the two most commonly nailed long bones in the body, and the application of an interlocking nail to a notoriously difficult fracture to treat—the proximal tibial fracture.


Intramedullary nail Biomechanics Poller screws Malalignment Femur Tibia Fracture 


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Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  • Damien F. Gill
    • 1
    • 2
  • Fouzia Khatun
    • 1
    • 2
  • Wasim S. Khan
    • 1
    • 2
  1. 1.Addenbrooke’s Hospital, Cambridge University Hospitals NHS Foundation TrustCambridgeUK
  2. 2.ORCA (Orthopaedic Research Collaborative East Anglia)CambridgeUK

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