Transport Intramedullary Nail for Nonunion

Nonunions with bone defects create technical challenges for fracture healing. All-internal bone transport with an intramedullary nail offers benefits over the other bone segment transport options including being simpler for the patients, avoiding the associated soft tissue issues that externally based implants or techniques and minimizing residual deformity by maintaining the anatomical axis along the intramedullary nail. This article reviews preoperative planning, technical tricks and specific techniques for internal bone transport, including the corticotomy, distraction, docking site and regenerate management, and the available literature.