What Is a Bone Nail?

Mary McMahon

A bone nail is a medical device used in repairs of fractured long bones like the femur. It goes inside the intramedullary space in the middle of the bone to stabilize it while it heals. Using bone nails isn’t suitable in all cases, but can be considered as an option for some types of fractures if it would appear to benefit the patient. Once the nail is placed, the patient may need follow-up appointments to confirm positioning and check for signs of irritation and other complications while the doctor monitors the progress of the healing.

A bone nail may be used to repair a fracture in the femur.
A bone nail may be used to repair a fracture in the femur.

Titanium and other materials with low corrosion are preferred for bone nail construction. Metals used in orthopedic implants need to be biocompatible so they don’t cause inflammation, scar formation, or pain for the patient. At the same time, they must be durable and strong enough to stabilize and support bone through the healing process, making it necessary to carefully select metals and alloys for use in orthopedic procedures. They are manufactured by medical device companies which sterilize and individually package them for shipment.

Some devices are rigid, and will not flex under stress. They are designed for severe, unstable fractures that cannot support weight and might become more unstable without adequate support. Others are flexible and provide more room for movement, making them particularly useful in more stable fractures as well as childhood breaks where the bone needs room to grow. The bone nail may be tipped with bolts to anchor it in place, depending on the design.

Before an orthopedic surgeon embarks on a fracture repair, medical imaging studies of the bone are evaluated to determine the nature of the fracture and develop a treatment plan. This allows the doctor to determine which approach should be used and to prepare the appropriate equipment. A bone nail may be used alone or with other devices to stabilize and support the bone while it heals. Initially, patients may need to wear a cast, later transitioning to braces because they can use the limb independently.

Many bone nails can be left in place after the procedure. In some cases, the bone nail causes infection or irritation and may need to be removed. This requires a second surgery to pull the nail out, inspect the site, and confirm that the bone is still stable. In some cases other stabilizing devices may need to be inserted, depending on the nature of the injury.

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