PROBLEM TO BE SOLVED: To provide an intramedullary fixation system that can prevent the increase of patients burden during operation due to the breakage of a shaft-shaped body (lag screw), the breakage of an intramedullary nail body and the large diameter of an intramedullary nail, prevent the setscrew of the lag screw and the end cap from coming loose and being isolated, or prevent detachment and sliding to the tip side.SOLUTION: An intramedullary fixation system is characterized by comprising: an intramedullary nail body 110 including a shaft hole 113 and a first transverse hole 114 a first engagement member 121A with a tip engagement part 121b capable of projecting in a first transverse hole and a first axial member 10 being the first axial member 10 inserted into the first transverse hole, and provided with an engaging recessed groove capable of being engaged to the direction rotating around an axis of the first axial member to the tip engagement part and an engagement structure capable of being engaged to the direction along the axis of the first axial member to the tip engagement part.SELECTED DRAWING: Figure 2COPYRIGHT: (C)2017,JPO&INPIT