Intramedullary Nailing (IM Nail)
A titanium rod inserted into the hollow central canal of a long bone stabilises shaft fractures from within — providing immediate load-sharing fixation that allows early weight-bearing and promotes predictable bone healing.
What is Intramedullary Nailing (IM Nail)?
Intramedullary nailing places a precisely sized metal rod inside the medullary canal — the central hollow channel running the length of the femur, tibia, or humerus. The rod is inserted through a small entry wound at one end of the bone and locked proximally and distally with interlocking screws to prevent rotation and shortening. Because the nail occupies the geometric centre of the bone, it shares compressive loading between the implant and the healing cortex — a mechanical environment that accelerates bone consolidation. Dr. Sai Kishan is AO Trauma Certified at the Advanced Level and performs IM nailing at Lux Hospitals using contemporary nail systems for the full spectrum of long bone shaft fractures.
How the Procedure Works
Pre-operative Planning & Imaging
X-rays confirm fracture location, displacement, canal diameter, and length; nail dimensions are planned and implant systems selected before surgery.
Anaesthesia & Patient Positioning
General or spinal anaesthesia; the patient is positioned on a traction or radiolucent table appropriate to the bone being nailed.
Entry Point Preparation & Canal Reaming
A small incision at the nail entry site allows the medullary canal to be sequentially reamed — widening it to accept the appropriately sized nail.
Nail Insertion & Interlocking Screw Fixation
The nail is driven down the canal to span the fracture; proximal and distal interlocking screws are inserted under fluoroscopy to prevent rotation and shortening.
Wound Closure & Mobilisation
Small incisions are closed; weight-bearing typically begins within 24–48 hours under physiotherapy guidance depending on fracture stability.
Outcomes
Who Needs This Treatment?
- →The definitive standard for femoral and tibial shaft fracture management
- →Load-sharing fixation encourages early mobilisation and quicker physiotherapy progression
- →Minimally invasive insertion — the fracture site is not directly opened
- →Significantly reduces malunion and non-union risk in diaphyseal fractures
- →Applicable to pathological fractures through bone weakened by tumour or disease
- →Decades of clinical evidence supporting consistent and reliable outcomes
The intramedullary nail is biomechanically elegant — it sits at the mechanical axis of the bone, shares the load, and lets the patient walk early. That early mobilisation is not just convenient — it is biological; it stimulates bone healing.
— — Dr. Sai Kishan Sirasala, Knee and Hip Joint Replacement & Robotic Surgery
Common Questions
Frequently Asked
Not sure which treatment is right for you?
Book a consultation with Dr. Sai Kishan and get a personalised treatment plan.