Intramedullary Nails: A Quick Guide

Fracture management, whether for the open or closed-type, is an intricate process that involves comprehensive postoperative care. Most importantly, using high-quality orthopedic implants that don’t corrode, cause infections, or damage surrounding soft tissue is vital to accelerate the recovery process. When it comes to using orthopedic implants for fracture management, intramedullary nails are among the top choices of surgeons. Before you start searching for a medical device supplier for intramedullary nails, it is advisable to understand what to look for. Continue reading as we present a quick guide to intramedullary nails.

Overview & History

Intramedullary nails or rods are a type of orthopedic implant that helps in stabilizing and supporting bones around fractures during the postoperative phase. IM nails are primarily used for long bones such as the Tibia, Humerus, and Femur. Intramedullary nails distribute the mechanical load and provide better “soft-tissue preservation” than other implants, which helps in ensuring quicker bone recovery. Over the centuries, IM nails have evolved gradually in terms of the type of material used and the scope of application. Some of the key developments in the history of IM nails are:

  • Wooden sticks soaked in antiseptic resins were used in the 16th century by Aztec physicians.
  • Development of intramedullary “ivory” cylinders for better bone alignment during the 1800s.
  • Titanium was used for the first time to make IM nails in the 1960s.


IM nails provide stability to the broken bone and play a vital role in re-developing the lost “muscle memory”, especially in long bones. Some of the instances where IM nails can be used are comminuted, transverse, pathological, and oblique fractures in Femur and Tibia. Apart from fractures, intramedullary nails are also beneficial in the treatment of non-union of bones after surgery.

Biochemical Classification

Today, several factors are considered during the development of intramedullary nails, one of which is their biochemical response after placing them at the required site. Based on this criterion, intramedullary nails can be classified into various types:

Coated IM Nails

Coated IM nails, as the name suggests, come with an external coating that helps in promoting bone recovery (Growth Factor Coating) and prevent infections (Custom-made Antibiotic and Antiseptic Coatings) at the affected site.

  • Growth Factor Coating (GFC): GFC IM nails feature an additional external layer of growth factors such as Insulin-like Growth Factor-1 (IGF-1), Bone Morphogenetic Proteins (BMPs), and Transforming Growth Factor-β1 (TGF-β1), which stimulates osteogenesis.
  • Custom-made Antibiotic Coating Cement: First discovered by “Klemm et al.”, these coated intramedullary nails help in treating previously developed infections rather than protecting the site from new microbes.
  • Antiseptic Coating: An antibiotic coating is an excellent way to prevent the development of opportunistic microbes. The IM nails feature “Silver-coated” external layers. Silver induces apoptosis and unlike anti-microbial drugs (due to antibiotic resistance), its effect can’t be slowed down.

Final Word

If you are looking to buy intramedullary nails, look no further than Madison Ortho. A trusted medical device supplier, we leverage extensive R&D and state-of-the-art manufacturing facilities to provide a complete range of high-quality intramedullary nails made from Titanium and Stainless Steel. To discuss your requirements, call +1-787-945-5800 or email at, and we will respond at the earliest.