Abstract
Intramedullary nailing is the mainstay of treatment for displaced closed or open tibial fractures. Acting as an internal splint, the nail facilitates healing and allows the patient early weight bearing. The use of metallic intramedullary devices dates back to World War I but this treatment was not fully accepted until Küntscher introduced his technique in the 1940s. The evolution with improvements in design and technique of intramedullary nailing has been ongoing since that time. This article examines the history, the advances, the outcomes, and controversies over the decades that have led to a treatment method that is largely successful if performed correctly and with appropriate indications.
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