Ukuthuthukiswa kokwelashwa kokuphuka kwesifazane kungalandelelwa emuva kuma-1940s lapho u-Kuntscher ethula indlela yokubopha izipikili ye-intramedullary evaliwe. Ukusetshenziswa kwezipikili ze-intramedullary (IMNs) ekuqhekekeni kwabesifazane sekuye kwaba indinganiso yokunakekelwa emashumini ambalwa eminyaka adlule, futhi ukuthuthukiswa kwamanje ekubetheleni kwe-intramedullary kanye nentuthuko kumasu okuhlinza kuye kwavumela ukwanda okuphawulekayo ekusetshenzisweni kwe-intramedullary nailing of the femur.