[Complications of intramedullary nailing and their prevention]

Interlocking nailing technique offers a wide variety of indications which are associated with an increased risk of complications. A consecutive series of 208 cases were analyzed and possible complications, how to avoid them and recommendations for treatment are given. The complications were divided into common complications--like infection, pseudarthrosis, malrotation, compartment-syndrome, disorders of the arterial and venous system, neurological deficts and fat embolism--as well as into specific complications--like malreduction of the fracture, malpositioning of the guide wire, splitting fragments and problems with nail insertion and with the locking bolts. There was a 8.7% common complication rate. Specific complications occurred intraoperatively in 3.5% and postoperatively in 11% of call cases. This seems to be a high rate which is decreasing by progressive experience of the surgeon. In many cases of shaft fractures interlocking nailing technique is the method of choice.