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The accompanying illustration is of a modification of the Steinman nail, used so commonly to obtain skeletal traction in fractures of the long bones. To the usual type of nail, a "shoulder" is braised at one end; this shoulder is so placed that it does not interfere with the skin wound or with the traction pieces. A sheath of steel tubing is fashioned over this end, long enough to fit against the shoulder and to clear the end of the nail. The blows cf the mallet are directed against the flat end of this sheath, and after the nail is in position the tubing is removed.
The chief annoyance in using the Steinman nail is that the nail sticks into the mallet at the end of the blow, and at the close of the operation the mallet is badly mutilated, and many times the nail also. If, as is a
Sonnenschein HD. A MODIFICATION OF THE STEINMAN NAIL. JAMA. 1927;88(4):243. doi:10.1001/jama.1927.92680300029010