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Updated: Mar 13, 2026

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Intramedullary Nail Fixation of Distal Tibia Fractures: Tips and Tricks
1*Department of Orthopaedic Surgery, Penn Presbyterian Medical Center, University of Pennsylvania, Philadelphia, PA; and †Orthopaedic Trauma and Fracture Service, Department of Orthopaedic Surgery, Penn Presbyterian Medical Center, University of Pennsylvania, Philadelphia, PA.
Abstract:
The objective of this article is to highlight the salient points of preoperative planning, intraoperative considerations for fracture reduction methods, and implant fixation when treating distal diaphyseal or diametaphyseal tibia fractures with an intramedullary nail. Through review of the necessary preoperative considerations, techniques available to hold and maintain a reduction, and lastly how to maximize the selected implant of intramedullary nail, we hope to assist the treating surgeon in simplifying these sometimes complex fractures into manageable injuries that can be treated successfully with an intramedullary implant.
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