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An intramedullary rod, also known as an intramedullary nail (IM nail) or inter-locking nail or Küntscher nail (without proximal or distal fixation), is a metal rod forced into the medullary cavity of a bone. IM nails have long been used to treat fractures of long bones of the body.
He first presented 12 cases of intramedullary fixation with rods at a surgical meeting in Berlin 03/18/40 and was met with general disapproval for using surgery for fractures [1] The German military initially disapproved of Kuntscher's IM nailing technique but introduced it in 1942.
Internal fixation refers to fixation of screws and/or plates, intramedullary rods and other devices to enable or facilitate healing. Rigid fixation prevents micro-motion across lines of fracture to enable healing and prevent infection, which happens when implants such as plates (e.g. dynamic compression plate) are used.
Intramedullary stabilization involves inserting a rod or nail into the tibial medullary canal. This offers structural support from within the affected bone, allowing for bone alignment and union. Surgeons may opt for flexible or rigid intramedullary nails depending on patient-specific factors such as age, pseudarthrosis severity and any ...
It usually occurs during a surgery which involves intramedullary nailing, which is the insertion of metal rods and nails to stabilise bones. Nailing is used as it requires minimal surgical dissection, less disruption of the fracture hematoma and allows faster functionality to a patient post-surgery.
For femoral shaft fractures, reduction and intramedullary nailing is currently recommended. [14] The bone is re-aligned, then a metal rod is placed into the femoral bone marrow, and secured with nails at either end. This method offers less exposure, a 98–99% union rate, lower infection rates (1–2%) and less muscular scarring. [14] [15] [17]
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In some settings they can be used for intramedullary fixation of bones such as the ulna. Tension band wiring is a technique in which the bone fragments are transfixed by K-wires which are then also used as an anchor for a loop of flexible wire. As the loop is tightened the bone fragments are compressed together.
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