A Comprehensive Guide to Tibial Nailing Systems for Short Segment Nailing Procedures

To characterize and compare interlocking screw configurations and design specifications of commercially available tibial intramedullary nail systems used for short segment fixation.

Data were collected in November 2025 from publicly available product information on manufacturer websites for tibial intramedullary nail systems marketed in the United States. Manufactures were identified based on established presence in the United States orthopedic implant market, including vendors listed at the 2025 Orthopaedic Trauma Association annual meeting. When required information was not publicly available, additional details were obtained through direct communication with manufacturer representatives via email correspondence and product specialists. Tibial nail systems were included if they were actively marketed and available for clinical use in the United States at the time of data collection. For each system, data were collected on interlocking screw hole quantity and position, nail diameter, total length, and relavant design features.

Thirteen tibial nailing systems were identified from ten manufacturers were identified and analyzed. Interlocking screw configurations varied across systems, with 3 to 5 proximal screws and 3 to 5 distal screws available, as well as differences in screw number and spatial distribution. Nail diameters, available lengths, and additional design features also varied among systems. The shortest proximal distance from the nail tip to the center of the second interlocking screw hole was 17mm and the shortest distal distance was 12mm.

This study provided a detail comparison of tibial nailing systems available in the United States, offering valuable information on nail specifications and screw positions. A comprehensive table and graphic representation serves as a practical planning resource for surgeons in the operative management of short segment distal tibial fractures, enhancing the selection of optimal implants for personalized patient care.

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