Nail

a fracture fixation device used to maintain position of fracture fragments during healing. Nails are thinner than rods but thicker than pins. An interlocking mechanism is incorporated into the nail design to resist rotation and telescoping at the fracture site.

The Kuntscher nail is rigid and cloverleaf-shaped in cross section, and it can expand when bone resorption occurs around it.

Ender nails are slightly curved; when multiple Ender nails are used, rotational stability is improved.

Complications of the use of nails include splitting of the shaft of the bone, inability to advance or withdraw the nail, separation of fracture fragments, penetration of the nail into an adjacent joint, pain from a prominent end of the fixation device, inadequate immobilization of the fracture (leading to nonunion), fracture at the site of Ender nail insertion, fat embolization, rod corrosion and spread of infection along the shaft of the bone. When sliding screw plate fixation is used, "cutting out" of the nail can occur but may be prevented by correct placement of the screw. Bending or breaking of the nail is usually caused by nonunion of the fracture.