What should you know about closed intramedullary nailing?

The surgeon aligns the bone using examination and imaging, inserts the nail through an entry point near the end of the bone, and may secure it with locking screws. The method aims to maintain alignment while the fracture heals.

Intramedullary means within the marrow canal. The nail shares load along the bone's axis, while locking screws can control shortening and rotation. Closed refers to preserving the skin and soft tissues over the fracture itself; separate small incisions are still needed to insert the implant and screws.

Suitability depends on the bone involved, fracture pattern, growth status, nearby joint, skin condition, circulation, and any contamination. Some fractures need an open approach if acceptable alignment cannot be achieved or tissue requires direct treatment.

Tell the trauma team about medicines, allergies, other health conditions, and when you last ate or drank. Do not put weight through the injured limb unless the team has said it is safe, and keep any temporary splint supported.

After surgery, weight-bearing instructions reflect fracture stability rather than the presence of a nail alone. Use crutches or a frame as taught, care for the wounds, take medicines as prescribed, and complete the planned exercises. Follow-up imaging checks alignment and healing before activity is advanced.

Obtain urgent medical assessment if pain rapidly intensifies despite medication, the limb becomes tense or much more swollen, sensation or movement changes, or the foot or hand turns pale, blue, or cold. These findings can indicate pressure, circulation, or nerve problems.

Call the treating team for fever, spreading redness, wound discharge, a wound that opens, new deformity, or a sudden inability to bear the permitted load. Emergency care is appropriate for chest pain, unexplained breathlessness, coughing blood, or collapse.

Confirm why a closed nail is suitable for your fracture, whether locking screws are planned, and what alignment the surgeon expects to restore. Request written instructions for weight bearing, wound care, movement, driving, work, follow-up imaging, and the circumstances in which the nail might need another procedure.