Serrano R, et al. - Researchers examined the effect of intramedullary nail (IMN) diameter, antegrade vs retrograde insertion, or the difference between the canal and IMN diameter on femoral shaft fracture healing. Retrospective analysis of a prospective database. They performed a retrospective analysis of a prospective database and included 484 fractures in the final analysis. Outcomes revealed similar healing rates regardless of IMN diameter, Δ canal-nail diameter after reaming, or insertion site. This indicates that consideration as the standard diameter for the treatment of acute femoral shaft fractures could be given to a closed section, cannulated, interlocked, titanium alloy IMN with a diameter of 10 mm, regardless of the entry point. This should be correlated with less reaming and therefore shorter operative times, and probably less hospital implant inventories as well. They recommend reserving larger diameter IMN for revision surgery.