Nails

Dr Oteki Misiani Victor

Introduction
These implants are introduced
into the bone remote to the fracture
site and share compressive,
bending, and torsional loads with
the surrounding osseous structures

IM nails act as internal splints

with load-sharing characteristics.
Flexible Nails
Rush pins

Ender nails

Morote Nails

Nancy Nails
Mechanics
Act by stabilizing fractures with three or
four point compression

Equilibrium between the tensioned pin

and the bone with its soft attached
tissues will hold the alignment.

Bending movements are neutralized but

telescopining and rotational torsion are
not prevented.
Applications
Children- Mainly for forearm fractures
femur fracture.

Adults-Clavicle fracture
Proximal humerus fracture
Humeral shaft fracture
Forearm fracture
Disadvantages
Additional immobilization is often required.

Secondary loss of reduction

Shortening with loading

Intramedullary Nailing
Unlocked Nail

Interlocking Nail

Unreamed Nail

Reamed Nail
Unlocked Nail
Interlocking Nailing
These nails have proximal and distal locking
screws.

The resistance to axial and torsional forces

is mainly dependant on screw bone
interphase.
Stability
Nail size

Number of locking screws or

bolts, and

Distance of the locking screw or

bolt from the fracture site.
Nail Diameter
Bending rigidity is proportional to the nail
diameter to the third power,

The torsional rigidity is proportional to the

fourth power
Unreamed nails
It is said that unreamed nailing is
advantageous in treatment of Gustilo IIIB
open fractures.
It has got less amount of superficial
infection and malunion as compared to
external fixation.
Disadvantages
Nonunion

Distal Screw breakage

Special Designs
Proximal Femoral Nails

Retrograde Nails

Distraction Nails

Knee Arthrodesis
Proximal Femoral Nail
Sub trochanteric fracture

Fracture NOF

Intertrochanteric Fractures
Retrograde Nails
Distal femur
fractures

Humeral fractures

Periprosthetic
fractures
Coated Implants
Hydroxyapatite

Growth Factors

Antibiotics