[Interlocking nailing of fractures of the proximal tibial shaft]

The anatomic construction of the proximal part of the tibial shaft induces high ventral traction forces. Consequently, the mechanical requirements for stability of any internal fixation system are also high. Therefore, interlocking nailing of fractures of the proximal tibial shaft demands a meticulous operative technique as far as the incision, implantation of the nail and the final interlocking are concerned. Typical complications in this area are axis deviation, loosening of the interlocking screws and delayed union. Particular attention should be paid to the risk of hitherto unnoticed fissures ascending into the tibial head.