Nailing of proximal and distal fractures of the femur: limitations and techniques.

Over the last 15 years, a continual evolution of nail design and techniques has made nailing at the extremes of the femur more commonplace. This evolution has yielded a better understanding and ability to control fractures of the metaphysis and, in the distal femur, even intra-articular fractures. With understanding of common pitfalls and reduction techniques, uneventful healing with anatomic alignment, rotation, and length can be achieved with nails at both far proximal and far distal fractures of the femur.