Skip to Content

Intramedullary Nailing

WHAT YOU NEED TO KNOW:

Intramedullary nailing is surgery to repair a broken bone and keep it stable. You may have a little bleeding from the wound for the first 24 hours after surgery. Stitches or staples used to close the surgery wound may be removed about 14 days after surgery.


DISCHARGE INSTRUCTIONS:

Call 911 for any of the following:

  • You feel lightheaded, short of breath, and have chest pain.
  • You cough up blood.

Seek care immediately if:

  • You have severe pain that increases when you stretch or bend the area.
  • Your skin is swollen, tight, or hard. It may be pale or shiny. The area may also be numb and hard to move.
  • Your wound is red, swollen, or draining pus.
  • You wound has a foul odor.
  • Your stitches or staples come apart.

Contact your healthcare provider if:

  • You have a fever or chills.
  • You have nausea or vomiting.
  • Your skin is itchy, swollen, or you have a rash.
  • You have questions or concerns about your condition or care.

Medicines:

You may need any of the following:

  • Prescription pain medicine may be given. Ask your healthcare provider how to take pain medicine safely.
  • Blood thinners help prevent blood clots. Examples of blood thinners include heparin and warfarin. Clots can cause strokes, heart attacks, and death. The following are general safety guidelines to follow while you are taking a blood thinner:
    • Watch for bleeding and bruising while you take blood thinners. Watch for bleeding from your gums or nose. Watch for blood in your urine and bowel movements. Use a soft washcloth on your skin, and a soft toothbrush to brush your teeth. This can keep your skin and gums from bleeding. If you shave, use an electric shaver. Do not play contact sports.
    • Tell your dentist and other healthcare providers that you take anticoagulants. Wear a bracelet or necklace that says you take this medicine.
    • Do not start or stop any medicines unless your healthcare provider tells you to. Many medicines cannot be used with blood thinners.
    • Tell your healthcare provider right away if you forget to take the medicine, or if you take too much.
    • Warfarin is a blood thinner that you may need to take. The following are things you should be aware of if you take warfarin.
      • Foods and medicines can affect the amount of warfarin in your blood. Do not make major changes to your diet while you take warfarin. Warfarin works best when you eat about the same amount of vitamin K every day. Vitamin K is found in green leafy vegetables and certain other foods. Ask for more information about what to eat when you are taking warfarin.
      • You will need to see your healthcare provider for follow-up visits when you are on warfarin. You will need regular blood tests. These tests are used to decide how much medicine you need.
  • Antibiotics may be given to help prevent or fight a bacterial infection.
  • Take your medicine as directed. Contact your healthcare provider if you think your medicine is not helping or if you have side effects. Tell him or her if you are allergic to any medicine. Keep a list of the medicines, vitamins, and herbs you take. Include the amounts, and when and why you take them. Bring the list or the pill bottles to follow-up visits. Carry your medicine list with you in case of an emergency.

Care for your wound

by keeping it clean and dry. Keep the wound dry when you shower. Cover the wound with a plastic bag. Tape the bag to your skin above the wound. Check your wound daily for signs of infection, such as redness, pus, or swelling.

Go to physical therapy

as directed. A physical therapist can teach you exercises to help strength your bones.

Apply ice

over the surgery area for 15 to 20 minutes every hour or as directed. Use an ice pack, or put crushed ice in a plastic bag. Cover it with a towel. Ice helps prevent tissue damage and decreases swelling and pain.

Elevate

your leg or arm above the level of your heart as often as you can. This will help decrease swelling and pain. Prop your arm or leg on pillows to keep it elevated comfortably.

Wear a compression stocking

as directed. This is a long, tight stocking that puts pressure on your leg to increase blood flow and prevent blood clots. You may need to wear the stocking all day. Your healthcare provider may tell you to continue wearing the stocking for several months after surgery.


Eat a variety of healthy foods

every day. Healthy foods include fruits, vegetables, whole-grain breads, low-fat dairy products, beans, lean meats, and fish. Your healthcare provider may recommend that you get more calcium and vitamin D. Calcium and vitamin D work together to strengthen bone. Your healthcare provider or a dietitian can help you create a meal plan.

Follow up with your healthcare provider as directed:

You may need to have x-rays over the first 6 months after surgery to make sure the fracture is healing. The locking screws may be removed after the bone heals. The nail is usually not removed. Tell your healthcare provider if you feel irritation or pain where the nail was placed. Write down your questions so you remember to ask them during your visits.

© 2016 Truven Health Analytics Inc. Information is for End User's use only and may not be sold, redistributed or otherwise used for commercial purposes. All illustrations and images included in CareNotes® are the copyrighted property of A.D.A.M., Inc. or Truven Health Analytics.

The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

Hide