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.
Indicated for diaphyseal (shaft) fractures of the femur, tibia, and humerus — including displaced, unstable, multi-fragmentary, and open fractures — and for pathological fractures through metastatic bone disease, where load-sharing fixation and early weight-bearing are the clinical goals.
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?
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The definitive standard for femoral and tibial shaft fracture management
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Load-sharing fixation encourages early mobilisation and quicker physiotherapy progression
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Minimally invasive insertion — the fracture site is not directly opened
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Significantly reduces malunion and non-union risk in diaphyseal fractures
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Applicable to pathological fractures through bone weakened by tumour or disease
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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
Intramedullary Nailing (IM Nail) Cost in Hyderabad
The cost of Intramedullary Nailing (IM Nail) in Hyderabad generally ranges from ₹1,00,000 to ₹2,20,000, with an average cost of around ₹1,60,000. The final expense can vary depending on the type and location of the fracture, the complexity of the procedure, implant selection, investigations, hospital stay and other treatment requirements.
| Procedure | Approximate Cost Range |
|---|---|
| Long bone shaft fractures | ₹1,00,000 ₹2,20,000 |
The final cost may vary based on fracture complexity, the bone involved, implant type, surgical requirements, duration of hospitalisation and any additional procedures required.
Factors Affecting Intramedullary Nailing (IM Nail) Cost
Several factors can influence the overall cost of intramedullary nailing, including the fracture characteristics, implant used and the level of care required before and after surgery.
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Type and location of the long-bone fracture
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Fracture complexity and displacement
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Type and quality of intramedullary nail and locking screws
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Pre-operative imaging, blood tests and other investigations
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Surgeon and operating-room charges
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Anaesthesia and medication costs
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Hospitalisation and post-operative monitoring
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Physiotherapy and follow-up care
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Additional procedures required for associated injuries or complications
Insurance Coverage for Intramedullary Nailing
Intramedullary nailing for a medically necessary fracture may be covered under health insurance, subject to the policy terms, hospital network status, approved package and applicable deductibles or exclusions. Patients should confirm their coverage and pre-authorisation requirements with their insurer before treatment.
- Checking your policy coverage
- Cashless approval process
- Required documentation
- Insurance-related queries before the procedure
Dr. Sai Kishan
Orthopaedic & Joint Replacement Surgeon
Consultation with an experienced orthopaedic trauma specialist is recommended to evaluate the fracture and determine whether intramedullary nailing is appropriate. At Lux Hospitals, the orthopaedic team can assess the injury and develop a treatment plan based on the fracture pattern, bone involved and overall health of the patient. During the consultation, the doctor may assess: Location and pattern of the fracture X-rays or other imaging findings Bone alignment and stability Soft-tissue condition around the fracture Need for surgical fixation and the appropriate implant Expected recovery, weight-bearing and rehabilitation plan
Consultation with Dr. Sai Kishan Sirasala Consultation with Dr. Sai Kishan SirasalaCommon Questions
Frequently Asked Questions
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