Intramedullary nail had been used for the treatment of long bone fractures since World War II. Gerhard Küntscher is credited with the first use of this device in 1939. Intramedullary fixation is valuable and appropriate for the majority of femoral shaft fractures, particularly for the mid-diaphyseal fractures. With the invention of newer nail designs and attention to surgical technique, nailing can be extended to both proximal and distal extraarticular fractures.