Abstract
The intramedullary nailing as a fixation device has a long history, which dates back to the 16th century and has evolved in various aspects. Now, it has become a gold standard for the treatment for diaphyseal fractures, with a good success rate, however the technique still has some drawbacks associated with it, but continued research regarding new mechanisms and devices can overcome these drawbacks. New osteosynthetic devices, such as intramedullary bone stents can be superior to current fixation devices, as they have a modulus of elasticity closer to that of bone, cause minimum soft tissue damage and trauma. Moreover, they can overcome complications posed by conventional devices, such as stress shielding and an inadequate blood supply. This review focuses on an evolutionary perspective of intramedullary devices used surgically for the repair of long bone diaphyseal fractures.
Highlights
Internal fixation methods have showed significant advancement in the treatment of fractures[9]
The internal fixation technique, intramedullary nailing has become a gold standard for the treatment of long bone diaphyseal fractures
Internal fixation devices allow micromovement, the fracture can heal by callus formation, if the implant is not applied correctly, it can result in complications, like malunion or non-union of the fractured site
Summary
Internal fixation methods have showed significant advancement in the treatment of fractures[9]. The internal fixation technique, intramedullary nailing has become a gold standard for the treatment of long bone diaphyseal fractures. With advancements and improved internal fixation techniques in the field of fracture treatment, complications, such as malunions and nonunions still exist, for which convincing methods are still not well defined[6]. Comparative studies have been made to evaluate the clinical results, complications and problems of reamed and undreamed IM nailing in the treatment of open tibial fractures. Unstable blood supply and tissue damage increase the risk of infection, as well as non-union. Reaming is not recommended for open fractures, as it can cause problems, such as temporary damage to the internal cortical blood supply, which is associated with increased rates of infection 25. It has been suggested that nails with a smaller diameter and increased strength allows them to be inserted without reaming[14]
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