Reviews of clinical outcomes led to the foundation of a new approach in fracture management known as biological osteosynthesis. As intramedullary rods featuring cannulations and locking devices at both extremities, interlocking nails are well suited for bridging osteosynthesis. Unique biological and mechanical benefits make them ideal for minimally invasive nail osteosynthesis and an attractive, effective alternative to plating, particularly in revisions of failed plate osteosynthesis. Thanks to a new angle-stable locking design, interlocking nailing indications have been expanded to osteosynthesis of epi-metaphyseal fractures, including those with articular involvement and angular deformities such as distal femoral varus and associated patellar luxations.