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Interlocking

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Intramedullary Nailing

Abstract

Interlocking of intramedullary nails can be cumbersome, time consuming, related to radiation exposure and complications. Several aiming devices have been described in the literature, but the fluoroscopy supported free-hand technique for drilling and screw insertion remains the most popular method. Fluoroscopy may result in considerable exposure for everyone inside the operating theatre. Other locking techniques include nail mounted tools, guides attached to an image intensifier, techniques based on C-arm image analysis, computer navigation, and self-locking nails.

It could be shown biomechanically, that metaphyseal screws failed at higher loads than diaphyseal screws. In small diameter nails, screw deformation can be limited or avoided by using the maximum number of locking options. Experimental and clinical studies could show no evidence for routine dynamization.

Typical complications associated with nail interlocking are screw breakage, screw loosening, nail damage, failure of targeting and pseudodynamization.

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Authors and Affiliations

  1. Klinik für Unfallchirurgie, Medizinische Hochschule Hannover, Carl-Neuberg-Strasse 1, Hannover, D- 30625, Germany

    Christian Krettek MD, PhD & Andreas Baumann MD

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  1. Christian Krettek MD, PhD
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  2. Andreas Baumann MD
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Correspondence to Christian Krettek MD, PhD .

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Editors and Affiliations

  1. Center for Orthopedics &Traumatology, University Medical Center Johannes Gutenberg University, Mainz, Germany

    Pol M. Rommens

  2. Academic Teaching Hospital Fulda, Fulda, Germany

    Martin H. Hessmann

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Krettek, C., Baumann, A. (2015). Interlocking. In: Rommens, P., Hessmann, M. (eds) Intramedullary Nailing. Springer, London. https://doi.org/10.1007/978-1-4471-6612-2_4

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  • DOI: https://doi.org/10.1007/978-1-4471-6612-2_4

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