Intramedullary Nail Fixation
A metal rod is inserted into the medullary canal of a long bone and locked with screws — the gold standard for femur, tibia, and humerus shaft fractures, enabling immediate weight-bearing and rapid mobilisation.
What is Intramedullary Nail Fixation?
An intramedullary (IM) nail is a metal rod that is introduced into the hollow medullary canal of a long bone, spanning the fracture and providing internal splinting from within the bone itself. Proximal and distal interlocking screws prevent rotation and shortening, providing a stable, weight-bearing construct. Intramedullary nailing is the gold-standard treatment for most femur and tibia shaft fractures, and is increasingly used for humerus, clavicle, and forearm fractures. The key advantage is that nailing is typically performed as a closed procedure — the fracture site is not opened, preserving the fracture haematoma and local biology that drive healing.
Suitable for femoral shaft, subtrochanteric, distal femur, tibial shaft, and humeral shaft fractures. Also used for pathological fractures through metastatic bone disease. Not suitable for very short, periarticular, or severely comminuted fractures near joints where plate fixation is preferred.
How the Procedure Works
Fracture Reduction
Patient positioned on a traction table; the fracture is reduced under fluoroscopic guidance — without opening the fracture site.
Entry Portal
A small incision is made at the nail entry point — piriformis fossa or trochanter for femur; tibial tuberosity for tibia.
Canal Preparation
The medullary canal is reamed to the appropriate diameter, creating a tight fit for the nail.
Nail Insertion
The IM nail is advanced across the fracture under fluoroscopic control until correctly positioned.
Interlocking & Mobilisation
Proximal and distal locking screws prevent rotation; weight-bearing begins the following day.
Outcomes
Who Needs This Treatment?
- →
Closed technique — fracture site not opened, biology preserved
- →
Immediate or same-week weight-bearing for lower limb fractures
- →
Nail within the bone — protected from impact forces
- →
Minimal blood loss compared to open plating
- →
Nail removal generally not required once union is confirmed
- →
Excellent biomechanical stability for long bone shaft fractures
"Intramedullary nailing is elegant surgery. We reduce the fracture without opening it, insert a nail through a small stab incision, lock it in place, and the patient walks the next day. Preserving the fracture biology by keeping it closed is one of the most important principles in fracture surgery."
— Dr. Satish Reddy Gandavarapu, Senior Orthopaedic Consultant and Trauma Surgeon , Lux Hospitals, Hyderabad
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 indicative average cost of around ₹1,60,000. Intramedullary nailing is a surgical method used to stabilise selected long-bone fractures by placing a metal nail within the medullary canal of the bone. The final cost depends on the fracture location and complexity, implant selection, associated injuries, surgical requirements and postoperative rehabilitation.
| Procedure | Approximate Cost Range |
|---|---|
| Intramedullary Nailing (IM Nail) | ₹1,00,000 – ₹2,20,000 |
The above range is indicative; the final package and inclusions should be confirmed with the hospital before publication. The cost can vary depending on the bone involved, fracture pattern, implant type, associated injuries and whether additional procedures are required.
Factors Affecting the Cost of Intramedullary Nailing
The overall cost of Intramedullary Nailing can vary depending on the fracture location, fracture pattern, bone condition, implant selection, associated injuries and complexity of surgical fixation.
- →
Fracture location and pattern: The bone involved and characteristics of the fracture, including displacement, comminution and stability, can influence surgical planning and fixation requirements.
- →
Implant selection: The type, length, diameter and design of the intramedullary nail and associated locking screws can affect the overall implant cost.
- →
Fracture complexity: Complex or highly unstable fractures may require additional fixation techniques, specialised implants or more extensive surgical planning.
- →
Associated injuries: Soft-tissue damage, additional fractures, joint involvement or other traumatic injuries may require further treatment and can increase the overall cost.
- →
Preoperative investigations: X-rays, CT scans, blood tests and other investigations may be recommended to assess the fracture and plan fixation. These may be billed separately when not included in the package.
- →
Anaesthesia and hospitalisation: Operating-room charges, anaesthesia, medicines, nursing care and hospitalisation may contribute to the overall treatment cost according to the hospital's package structure.
- →
Postoperative rehabilitation: Physiotherapy, weight-bearing progression, follow-up imaging and rehabilitation may be required during recovery. Some rehabilitation-related services may be billed separately.
Insurance Coverage for Intramedullary Nailing
Intramedullary Nailing may be covered by health insurance when medically necessary for fracture treatment, subject to the patient's policy terms, exclusions, waiting periods, insurer approval and hospital coverage arrangements. Patients should confirm pre-authorisation requirements, implant coverage and applicable out-of-pocket expenses with their insurer before treatment.
- Checking your policy coverage
- Cashless approval process
- Required documentation
- Insurance-related queries before the procedure
Dr. Satish Reddy Gandavarapu
Orthopaedic & Joint Replacement Surgeon
Dr. Satish Reddy at Lux Hospitals, Hyderabad, can evaluate patients with long-bone fractures and determine whether intramedullary nailing is an appropriate fixation method based on the fracture pattern, bone condition, associated injuries and imaging findings. During the consultation, the doctor may assess: Fracture symptoms: The doctor may review pain, swelling, deformity, inability to bear weight or use the affected limb and other symptoms following the injury. Fracture pattern: X-rays and, when indicated, CT scans may be reviewed to assess the location, displacement, comminution and stability of the fracture. Bone and soft-tissue condition: The condition of the surrounding bone, muscles, skin and other soft tissues may be evaluated before deciding on the fixation method. Neurovascular status: Blood circulation, sensation and movement of the affected limb may be assessed to identify associated nerve or vascular concerns. Associated injuries: Additional fractures, joint injuries or other trauma-related conditions may be evaluated because they can influence the overall treatment plan. Implant suitability: The doctor may determine the appropriate nail size, fixation strategy and whether additional fixation or another surgical approach may be required. Recovery planning: Expected weight-bearing restrictions, follow-up imaging, physiotherapy and rehabilitation requirements may be discussed as part of postoperative planning.
Consultation with Dr. Satish Reddy Consultation with Dr. Satish ReddyCommon Questions
Frequently Asked Questions
Not sure which treatment is right for you?
Book a consultation with Dr. Satish Reddy and get a personalised treatment plan.