Intramedullary Nailing
For fractures of the thigh, shin and upper arm, a nail passed down the hollow centre of the bone holds the fracture from the inside. Because the load runs through the middle of the bone, patients can often bear weight much sooner than with a plate.
- Rod inside the bone, not a plate outside
- Small incisions away from the fracture
- Earlier weight bearing than plating
- Less disturbance of the fracture site
Stay
2 to 4 days
Duration
1 to 2 hours
Anaesthesia
General or spinal
About Intramedullary Nailing
The nail is inserted through a small incision at the end of the bone and passed across the fracture, then locked with screws at each end. Because the fracture itself is not exposed, the blood supply around it is preserved, which helps healing. It suits the long bones of the leg particularly well, where weight bearing matters most.
- The fracture site is not opened, preserving blood supply
- Locking screws control rotation and length
- Especially suited to thigh and shin fractures
- Weight bearing usually starts earlier than after plating
Before you read on
Everything here is general information about intramedullary nailing. Whether it suits you, and how it would be done in your case, is a decision for your doctor after examining you.
Your consultant's instructions always take precedence over anything written on this page.
When is it recommended?
Situations in which a doctor may suggest intramedullary nailing.
- Fractures of the femur or thigh bone
- Fractures of the tibia or shin bone
- Some humerus or upper arm fractures
- Fractures around the hip in certain patterns
- Fractures that have failed to unite
- Some pathological fractures
Procedure details
The usual sequence, from first consultation through to follow-up.
Planning
X-rays determine the fracture pattern and the correct nail length and diameter, which are selected before theatre.
Insertion
A small incision at the end of the bone, the canal prepared, and the nail passed across the fracture under C-arm guidance.
Locking
Screws are placed through the nail at each end to control length and rotation, through further small incisions.
Early mobility
Depending on the fracture, weight bearing often begins within days, with physiotherapy from the first day.
How to prepare
What to sort out before you come in.
- Usually done as an emergency after injury
- For planned surgery, fasting as instructed and blood tests beforehand
- Tell the team about blood thinners and previous metalwork
- Stop smoking if possible, as it slows bone healing considerably
- Arrange help at home, particularly for lower limb fractures
Recovery
What to expect afterwards, and roughly when.
- Weight bearing often starts within days, though it depends on the fracture pattern
- Knee or shoulder pain near the insertion point is common and usually settles
- Union usually takes three to four months for the femur and tibia
- Physiotherapy for strength and movement continues for months
- The nail is usually left permanently unless it causes symptoms
Why choose Humayun for intramedullary nailing
Nailing works because the fracture is never opened, and that depends on good imaging during surgery.
- C-arm imaging throughout, since the fracture is reduced without being seen directly
- A range of nail sizes held on site rather than ordered case by case
- Emergency theatre available at any hour for femoral fractures, which should not wait
- Physiotherapy from the first day, because early weight bearing is the main advantage
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