[The value of dynamic adjustment in locking intramedullary nailing]

The so-called "dynamization", i.e. the removal of defined bolts after the first signs of osseous consolidation detected by X-ray film 6 to 10 weeks after surgery employing the static locking nail technique, cannot be translated into reality. In a total of 121 patients in whom static locking nail technique had been employed, dynamization was effected in 23 cases only, i.e. 19%. Complications are likely to occur if the indication for dynamization was wrong or if dynamization is not performed although it was indicated. Dynamization must be prescribed individually on the basis of X-ray film controls and is actually indicated in rare cases only. We refuse to perform it as a routine step after static nail locking of the femur and tibia.