Interlocking Nails: Why They Work (and When They Don’t)

In this BoardCast episode, we break down the mechanics, applications, and complications of one of the most powerful tools in internal fracture fixation: interlocking nails.

From biomechanical advantages to real-world complications, we cover:

• Why nails work so well for comminuted diaphyseal fractures
• The difference between static and dynamic locking — and when to use each
• Area moment of inertia, angular stability, and central vs. eccentric loading
• When ILNs outperform plates and pins — and when they don’t
• Failure risks, from screw misses to biological complications
• How newer angle-stable designs may push outcomes even further

This is essential knowledge for any surgeon thinking critically about mechanics, biology, and construct design in orthopedic repair.

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