Intramedullary cortical fragments: Recognition and techniques to permit safe nailing
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Updated: Apr 4, 2026

Treatment with Locking Intramedullary Nailing for Intertrochanteric Fracture of the Femur Utilizing a New Awl with a Distal Positioner
Published on: June 6, 2025
William Rainer1, Mark E Hake2, Cyril Mauffrey3
1Kirksville College of Osteopathic Medicine, Kirksville, MO, USA.
Abstract:
The presence of a cortical fragment blocking the intramedullary canal is a challenging problem in the management of comminuted long bone fractures. Recognizing this problem and removing the cortical fragment are crucial to prevent complications from occurring. We present a simple technique to remove intramedullary fragments from within the canal to allow for safe nailing.
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