Complications of Intramedullary Nailing

  • Marschall B. Berkes
  • Milton T. M. Little
  • Dean G. Lorich


Intramedullary nailing offers a safe and reliable means of osteosynthesis. Complications encountered when performing intramedullary fixation are malalignment, infection, hardware failure, impaired bony healing and neurovascular injuries. Primary malalignment is largely a consequence of either an inappropriate entry point or fracture site malreduction. Secondary malalignment refers to a change in fracture reduction and alignment at some point during the postoperative period. Hardware failure is seen when the implant sustains more load than intended, either due to early excessive weight bearing or prolonged cyclical loading, as in a non-united fracture. Infection can result in secondary operations, increased risk of secondary complications, delayed/nonunion and worse clinical outcome for the patient.


Primary and secondary malalignment Hardware failure Infection Delayed union Nonunion Neurovascular Complications Impaired bone healing Malrotation Entry point Varus Valgus 


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Copyright information

© Springer-Verlag London 2015

Authors and Affiliations

  • Marschall B. Berkes
    • 1
  • Milton T. M. Little
    • 1
  • Dean G. Lorich
    • 2
  1. 1.Orthopaedic Trauma ServiceHospital for Special SurgeryNew YorkUSA
  2. 2.Orthopaedic Trauma ServiceHospital for Special Surgery, New York Presbyterian Hospital/Weill Cornell Medical CollegeNew YorkUSA

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