[Intramedullary compression nailing of long tubular bones]

The biomechanical principle of intramedullary compression osteosynthesis is based on the implantation of a movable intramedullary nail that is statically interlocked in distal round holes and dynamically interlocked in a proximal slot. Distraction of the nail against the proximal interlocking screw by means of a compression screw leads to a relative movement of the proximal fragment directed distally against the nail. This results in direct contact of the main fragments under increasing compression. Simple fractures, pseudarthroses and osteotomies within the diaphyses of the long bones represent promising indications for the use of compression nailing. Furthermore, this method enables extraordinarily stable knee and ankle arthrodeses. Major positive aspects are controlled adaptation of fragments and a significantly increased stability of the fracture as compared to conventional intramedullary nailing techniques, especially as rotational forces are concerned. The biomechanical advantages result in earlier full weightbearing and an increased rate of fracture union in delayed healing. Given the use of optimized implants and instruments, compression intramedullary osteosynthesis offers a remarkable potential for further improvement in both the spectrum and success of intramedullary nailing.