Understanding Your Intramedullary NailAdvanced Care for Broken Bones More than likely, you’re already familiar with the non-surgical approaches that physicians use to help fractures heal. A doctor applies casts, braces, or splints around the affected area in order to hold the broken bone securely in position and provide support while the body repairs itself. In some cases however, particularly fractures of the long bones, today’s best orthopaedic treatment includes securing the fracture internally with a metal intramedullary nail implanted by surgical procedure. Your doctor has provided you with this booklet to answer some of the questions you may have about your broken bone and fracture treatment. It will also help you better understand what to typically expect over the next few days and weeks as you leave the hospital, begin physical therapy and follow up with your orthopaedic surgeon and physical therapist. What is an Intramedullary Nail? To align the fractured bones and provide optimal healing support, the orthopaedic surgeon makes a small incision through the skin and tissue closest to one end of the broken bones. The surgeon then inserts a small rod-like nail device into the hollow center of the bone, called the medullary cavity. The intramedullary nail forms a self-contained internal splint to stabilize the fracture. This is often done for fractures of the tibia (see below), femur (thigh), and humerus (shoulder). Potential Advantages of the Intramedullary Nail ØProvides durable, strong and flexible support. ØAllows more exact alignment of the fractured bones for faster healing and may lead to earlier weightbearing.1 ØMay lead to earlier joint motion for reduced stiffness.1 ØEncourages more natural-like motion in uninjured muscles and neighboring joints. In the Hospital, What Now? Together, you and your orthopaedic surgeon will decide on a course of aftercare that’s most appropriate for you. The full length of your care may span several months. Rehabilitation will begin in the hospital and continue with outpatient physical therapy sessions, as well as at home. Understanding your care may help you feel more comfortable throughout the healing process. How do I care for the new incision sites? The steps required to care for your wounds at home are described on page 3 within the section “At Home. Where Do I Go from Here?” Why take additional X-rays? How does physical therapy help me heal? A physical therapist will work closely with you to select the most appropriate treatment and exercises to help you restore your range of motion and rebuild muscle strength. At Home, Where Do I Go from Here? Prior to being discharged, be sure to ask for an at-home recovery plan. Should you have questions later, contact your surgeon directly. The information that follows can help you make a smooth transition home while your fracture heals. How do I care for the healing incision sites? This is what your doctor will typically advise: 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 What precautions should I take? Further Precautions Your Surgeon Will Likely Give: ØBe careful with stairs, rugs and loose shoelaces. ØAvoid contact with animals. ØAvoid contact with dust and dirt. ØAvoid unnecessary handling of your incision sites. What if I suspect a skin infection? Will your nail be removed? For more information, contact your physician. Reference: 1. Thomas Mueckley, Oliver Gonschorek, and Volker Buehren, “Compression Nailing of Long Bones,” European Journal of Trauma, 2003; 29:113-28. |