Medicine: The Nail

When the Russians entered Vienna last year, a party of Red Army surgeons stomped into the Hospital for Accidents. “Where is Bohler?” they demanded. “We want the nail.” Dr. Lorenz Bohler, one of the best orthopedic surgeons in Europe was away—in a French prison camp. But the Russians got “the nail.” By last week most of the rest of Europe had it too. The nail,* which Austrian Surgeon Bohler had used with wide success, is a remarkable device for mending broken bones, especially broken thighbones.

Not to be confused with more conventional metal splints which are attached outside, the nail is driven into the marrow of the bone. In cases of broken femurs, the surgeon first manipulates the thigh to bring the broken pieces of bone together, using a fluoroscope to see what he is doing. Then, through a one-inch incision in the hip over the end of the bone, he rams a guide wire down through the bone’s marrow canal. He slips the hollow, stainless-steel nail over the wire, hammers it in the full length of the bone, pulls out the wire and sews up the incision.

In a week or two, normally, the patient walks out of the hospital without crutches (with conventional treatment it may take months). Later, a surgeon pulls out the nail, and the healed bone is as good as new.

U.S. surgeons first heard of the nail when captured G.I.s released from German prisons began to turn up with it inside their thighbones (TIME, Mar. 12, 1945). U.S. surgeons thought it presented serious danger of infection and interference with the blood supply (red blood cells are manufactured by bone marrow).

Last week their fears were dispelled. Surgeon Bohler, now back in Vienna, has performed nearly 400 nail operations, on old fractures as well as new, without a single infection. No interference with the blood supply has been observed. Bohler recently published description of the operation, Die Marknagelung Nach Kuntscher is one of the most sought-after medical books in Europe, and the German factory in Kiel which makes the nails is far behind demand.

*Its inventor: German Naval Surgeon Gerhardt Kuntscher.