A review and critical analysis of the history of intramedullary nailing

Abstract

Although intramedullary nailing (IMN) rapidly grew during the 1980s and 1990s to become the standard of care for most diaphyseal femur and tibial fractures as well as peri-trochanteric hip fractures, its history dates back over a century. While IMN has gone through multiple generations, its evolution has been cyclical, several techniques being introduced, abandoned, and subsequently re-introduced. While knowledge of the evolution of intramedullary nailing can help guide future advancements in IMN, it is also important for practicing surgeons to understand the principles and foundations of IMN as its indications expand to other areas such as humeral and fibular fractures. This review presents a review and critical analysis of the history of IMN from its origins to future directions, including how various surgeons’ experiences with IMN shaped its evolution from Küntscher’s original marrow nail to the current generation of intramedullary nails.