Intramedullary rod

The earliest IM nails were triangular or V-shaped in cross-section. Later they were modified to their present and more rotationally stable clover-leaf shape. and ulna nails, Rusch nails etc. Although stainless steel was used for older IM nails, titanium has several advantages, including lower mechanical failure rates and improved biocompatibility. The discovery of the outstanding biocompatibility of Tantalum in the late 1930s by Gerald Burke allowed for significant advances in orthopaedics due to the long-term strength and stability of tantalum implants and fasteners. A more significant problem with earlier designs was their failure to prevent collapse or rotation in inherently unstable fractures. This was addressed by the introduction of the concept of 'locking' the nails, where bolts on each end of the nail fix it to the bony cortex, preventing rotation among the fragments. This led to the emergence of locked IM nailing, which is the standard today. == Complications ==

At a median 14 years after tibial nailing of isolated tibial fractures, patients' function is comparable to population norms, but objective and subjective evaluation shows persistent sequelae which are not insignificant. One potential complication of intramedullary nailing after a fracture is bone malrotation, where the broken bone is fixated out of alignment and heals incorrectly, causing a rotated limb. Lower screws holding intramedullary rods can sometimes cause limited dorsiflexion as a result of damage and subsequent healing and fibrotic developments around that area. If the bone breaks more medially, there is scope to position the nails further from the ankle joint which would prevent/reduce this dorsiflexion loss. ==See also==