الفهرس 
History of intramedullary NailingOnly 14 pages are availabe for public view
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Abstract
Since the appearance of the modem intramedullary nailing techniques about 50 years ago, the interest in this method as a dependable method for management of long bone fractures is increasing progressively. Sound Knowledge of the principles and techniques of internal fixation of fractures, in addition to proper understanding of the close relationship between biological, anatomical and mechanical aspects and the results of internal fixation of fractures using intramedullary implants is cornerstone management of fracture. Anatomically, the femur has a nearly round cross section and also have a gentle uniform anterior bowing through out its length. The tibia have a triangular cross section with a round medullary cavity, while the humerus is large and round in cross section at its midshaft, and assumes a trumpet shape in its media lateral plane. The blood supply of long bones is drived from three different sources: (1) The principal nutrient artery. (2) The metaphyseal arteries. (3) The periosteal arteries. Intramedullary nails stabilize fractures fragments and maintain alignment, while permitting micro-motion at the fracture site. Acting as an internal splint, intramedullary nail serves as a load sharing device and fracture healing progresses with the formation of external callus. 96 Experimental studies shows that when a wel1 fitting nail is used for stabilization of fractures using a closed technique, union takes place promptly this is because of the enchondral bone formation, and direct bone formation in the organizing fracture haematoma., on the other hand regeneration of the medul1ary circulation takes place slowly. If a loose fitting nail is used the regeneration of the medul1ary circulation occurs faster but healing occur by excessive periosteal reaction combined with extensive remodeling of the old cortex and resorption of the cortical ends. A perfect intramedul1ary nail has not been designed but continuous improvements of designs, instruments and materials allow for the appearance of new devices with more advantages. All intra medullary devices can be classified into three groupS 1- Centromedullary nails. 2- Condylocephlic nails 3- Cephalomedullary nails. After the appearance oflocked nails each group ofthese is subdivided into locked & non locked. Smith & Nephew Richard interlocking nail system was designed with two main goals. The first is to improve the results of previously available nails by reducing the complications. The second was to extend the indication 01 interlocking nails to involve more complex pattern of fractures.