🔍 Key Findings Summary
- IMN provides relative stability, resists bending/torsion due to central axis alignment
- Larger diameter nails = exponentially greater stiffness (∝ D⁴)
- Trade-off: Larger interlocking holes weaken fatigue strength of the nail
- Reaming increases contact/stability but has pros/cons:
- Improves outcomes in closed fractures
- May reduce endosteal blood flow in thin-walled bones (e.g., cats)
- Design advances:
- Angle-stable IMN reduce rotational slack
- Expandable nails simplify insertion but may compromise removal or compressive load resistance
- Precontoured nails match bone curvature but lack consistent clinical superiority
- Material debates continue (e.g., titanium vs. stainless steel vs. magnesium)
