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Biomechanics of Intramedullary Nails Relative to Fracture Fixation and Deformity Correction

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Essential Biomechanics for Orthopedic Trauma


Modern intramedullary nailing began in the World War II era with Gerhard Küntscher’s intramedullary implants. Multiple design advances have followed, and medullary nailing has become the workhorse in the armamentarium of the orthopedic trauma surgeon for long bone fracture and deformity care. Current nail design features that have an effect on nail biomechanics include the following: material (metal) properties, cross-sectional shape, diameter, curvature of the nail, and the ability to place interlocking devices (such as bolts). Extrinsic factors, such as reaming of the medullary canal, inherent fracture stability (fracture pattern, including comminution or spiral configuration), and the use of adjuncts for stability (such as blocking or “poller” screws), also affect biomechanics of fracture fixation. This chapter will describe biomechanics of intramedullary nailing, with illustrative examples.

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Correspondence to Gregory J. Della Rocca .

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Woods, J.C., Della Rocca, G.J. (2020). Biomechanics of Intramedullary Nails Relative to Fracture Fixation and Deformity Correction. In: Crist, B., Borrelli Jr., J., Harvey, E. (eds) Essential Biomechanics for Orthopedic Trauma. Springer, Cham.

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