IM

Nailing
Procedural report

Kirsty Supranes BSN3B

 Intramedullary nailing

is an internal fixation technique mainly

used for the surgical management of long
bone diaphyseal fractures and since more
recently, also in metaphyseal and
periarticular fractures.
 Purpose
to repair a broken bone and keep it stable
 To restore the load axis

acts as a splint. It’s

function is to restore the Avoid malrotation
length of limb
Incomplete: Fracture involves only a
portion of the cross-section of the bone.
One side breaks; the other usually just
bends (greenstick).
Complete: Fracture line involves entire
cross-section of the bone, and bone
fragments are usually displaced.
Closed: The fracture does not extend
through the skin.
Open: Bone fragments extend through the
muscle and skin, which is potentially
infected.
Pathological: Fracture occurs in diseased
bone (such as cancer, osteoporosis), with
no or only minimal trauma.
 Instruments used for IM nailing
Tibial nails Reamer Surgical Mallet

Scalpel Locking screw guide wire

C Arm X-ray
 Surgical technique
Administered general anesthesia Opening of entry point Guide wire is inserted

Enlarging the canal by reaming Nail insertion Locking screws

 Nail cap
Distal locking
Nursing
responsibilities
Pre-operative care
Check for blood type and
Obtain informed consent cross matching

Informed the patient about

Review the pre operative the surgical procedure and
laboratory and diagnostic expectation before and after
studies surgery

Instruct patient to take a Instruct client to trim and

bath prior to surgery remove nail polish or any
cosmetics
Intraoperative care
Ensure proper room
Identify the patient and
temperature, humidity and
surgery to perform
lighting in OR.

Maintain patient safety Monitors aseptic technique

while coordinating the
movement of related
personnel
Ensure that supplies and
materials are available for
use during surgical
procedures
Post operative care
Discuss individual Review proper pin and
postoperative pain wound care Discuss the importance of
management plan clinical and therapy follow-
up appointments.
Discuss dietary needs Discuss individual drug
regimens as appropriate

Reinforce methods of
Instruct patient to acquire
mobility and ambulation as Encourage the patient to discharge slip and process
instructed by a physical continue active exercises for billing
therapist when indicated the joints above and below
the fracture.
supine high-flexion knee position