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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.
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.
Küntscher invented what is known as the Küntscher nail, an internal fixation device used to maintain the position of the fracture fragments during healing. The nail is rigid and has a cloverleaf shape in cross-section. Küntscher first performed the process using the nail in November 1939 at the University Department of Surgery in Kiel.
Fixation in orthopedics is the process by which an injury is rendered immobile. [1] This may be accomplished by internal fixation , using intramedullary rod , Kirschner wire or dynamic compression plate ; or by external fixation , using a spanning external fixator , Taylor Spatial Frame or Ilizarov apparatus .
After definitive fixation they are then removed. The pins are usually removed four weeks post operation. [1] They can be used for definitive fixation if the fracture fragments are small (e.g. wrist fractures and hand injuries). In some settings they can be used for intramedullary fixation of bones such as the ulna.
The use of intramedullary rods to treat fractures of the femur and tibia was pioneered by Gerhard Küntscher of Germany. This made a noticeable difference to the speed of recovery of injured German soldiers during World War II and led to more widespread adoption of intramedullary fixation of fractures in the rest of the world.
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Intramedullary is a medical term meaning the inside of a bone. Examples include intramedullary rods used to treat bone fractures in orthopedic surgery and intramedullary tumors occurring in some forms of cancer or benign tumors such as an enchondroma .