ABSTRACT
The fracture is reduced by traction, either on an orthopaedic operating table, or with a distractor. Through an entry site remote to the fracture, the canal is entered and the nail inserted. If reaming is desired, a guide wire is passed and the canal expanded by serial reaming. Depending on the flexibility of the nail, the canal should be reamed to a diameter 0.5 to 1.5 mm greater than the intended implant. If the fracture configuration is unstable, the nail should be locked proximally and distally. If closed reduction cannot be achieved, the fracture site must be opened.
