Locked nailing of the femur and tibia: minimizing operative difficulties

The technique of closed intramedullary nailing has inherent operative difficulties and complications, which are especially evident and costly to the surgeon just beginning to become familiarized with the procedure. Practical advice about the techniques of closed femoral and tibial nailing to improve awareness of the possible problems is provided. The nailing procedure is analyzed in a step-by-step fashion from pre-operative planning to locking. Accurate pre-operative planning for the procedure to run smoothly is mandatory.