First Department of Orthopaedics, National and Kapodistrian University of Athens, School of Medicine, Athens, Greece.
Second Department of Anesthesiology, National and Kapodistrian University of Athens, School of Medicine, Athens, Greece.
Int Orthop. 2021 May;45(5):1355-1361. doi: 10.1007/s00264-021-04973-y. Epub 2021 Feb 11.
To summarize the evolution of intramedullary nailing, highlight important milestones, introduce the atmosphere of the era concerning the first uses and development of intramedullary nailing, and present the status of nailing in modern international orthopaedics and traumatology.
A thorough literature search was undertaken in PubMed and Google Scholar as well as in physical books in libraries to summarize the literature on the history and evolution of intramedullary nailing.
The first use of an intramedullary device was attested in ancient Egypt; however, the first use of intramedullary nailing was reported in 1524 in Mexico, and the first medical journals reported on intramedullary nailing around the mid-1800s. The evolutions of intramedullary nailing including approach, material, cross-section and shape, and reaming technique occurred in the twentieth century. During the 1960s, intramedullary nailing was abandoned in favour of plate and screws osteosynthesis; however, in the 1970s, 1980s, and 1990s, a surge of novelties including flexible reaming, interlocking, and use of image intensification and titanium nails led to the advent of the second-generation intramedullary nailing. Today, intramedullary nailing has become the standard treatment of long bone fractures with low infection rates, small scars, excellent stabilization of the fractures, and immediate mobilization of the patients.
Intramedullary nailing has revolutionized the treatment of long bone fractures. However, with numerous nail designs, a lot of information on their efficacy is lacking. Considerably more work will need to be done to determine the optimal nail specifications.
总结髓内钉的发展历程，重点介绍其首次使用和发展的重要里程碑，介绍髓内钉应用的时代背景，展示现代国际骨科和创伤学中髓内钉的现状。
在 PubMed 和 Google Scholar 以及图书馆的实体书籍中进行了全面的文献检索，以总结髓内钉的历史和发展的文献。
最早使用髓内装置的证据可以追溯到古埃及，但髓内钉的首次使用是在 1524 年的墨西哥报道的，而最早的医学期刊是在 19 世纪中叶左右报道髓内钉的。髓内钉的发展包括入路、材料、横截面和形状以及扩髓技术，都发生在 20 世纪。20 世纪 60 年代，髓内钉被放弃，转而采用钢板和螺钉固定；然而，在 20 世纪 70 年代、80 年代和 90 年代，髓内钉的出现带来了许多创新，包括灵活扩髓、交锁、以及使用影像增强和钛钉，这导致了第二代髓内钉的问世。如今，髓内钉已成为治疗长骨骨折的标准方法，其具有感染率低、疤痕小、骨折固定稳定以及患者可立即活动等优点。
髓内钉彻底改变了长骨骨折的治疗方法。然而，由于存在众多的钉设计，缺乏关于其疗效的大量信息。需要做更多的工作来确定最佳的钉规格。
