الفهرس 
IntroductionOnly 14 pages are availabe for public view
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Abstract
Intramedullary nailing is the most common treatment for diaphyseal fractures of long bones. Hey Groves designed his first intramedullary nail in 1917. Gerhard Kuntscher introduced the technique of intramedullary nailing to clinical practice during the 1940s, and this method has revolutionized the treatment of diaphyseal fractures. Kuntscher’s interest was in the response of fractured bone to an implant placed in the medullary canal.
With this great advance in medullary fixation, the surgeon must choose between internal immobilization by plating or intramedullary nailing when contemplating internal fixation of fractures and non-unions of diaphyseal bones. With the correct indications and proper surgical techniques excellent results can be achieved with either methods. Recently, there has been renewed interest in intramedullary fixation, particularly with the advent of interlocking nail system. Our essay is a trial to understand the biology of fracture healing with particular reference to types of intramedullary devices, their mechanics and their indications.
Mechanically, a medullary nail represents a gliding splint.
Motion at the fracture site is reduced but not eliminated.
Fixation is based mainly on elastic three-point contact in a longitudinal direction.
Rotational stability following conventional nailing is limited. Additional rotational stability is provided by muscular activity and interfragmentary interdigitation.
The interlocking nail allows for insertion of screws through the nails and the bone in the proximal and the distal
fragments, preventing shortening, tilting and torsional displacement.