Limb lengthening and reconstruction: Intramedullary nail

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Find out how a motorized intramedullary nail helps lengthen your child's limb.

Key points

  • A motorized intramedullary nail can lengthen and sometimes also straighten a bone.
  • The nail is placed inside the bone during surgery and has a special motor that responds to a remote control. The remote control is programmed with instructions from your child’s surgeon.
  • Your child will need to use crutches to help them walk while the nail is in place.

A motorized intramedullary nail is a type of internal limb lengthening device. Sometimes it can also straighten a crooked bone while it lengthens it.

The main difference between this device and the Taylor Spatial Frame and monolateral rail is that there are no pins or frames outside the skin. This makes the device more comfortable for a child. The nail's location inside the leg also makes it easier to find suitable clothes to wear.

The device is not suitable for all types of limb lengthening, but your surgeon can discuss with you whether it would be a good option for your child.

How is the motorized intramedullary nail attached to the limb?

Your child will have surgery to have the nail inserted inside the bone that needs to be lengthened or corrected.

During the surgery, the surgeon performs an osteotomy to divide the bone. This allows the nail to lengthen or correct the limb over time.

How does the intramedullary nail work?


The nail contains a special motor that allows it to extend in much the same way as the lens of a telescope. This lengthening of the nail gradually spreads apart the bone at the point where it was divided during surgery. Over time, new bone grows in the space that is created.

Once the bone has achieved its target length, the nail is left in place until the new bone sets hard. This may take many months.

When the bone has healed, your child will have another surgery to remove the motorized nail. The surgeon will replace it with a solid metal nail to protect the newly lengthened bone.

Programmed adjustments

The motor inside the nail is controlled by a magnetic external remote control. This remote control contains instructions based on a program developed by your child’s surgeon before limb reconstruction surgery. The surgeon will review your child’s X-rays at clinic appointments and may use them to adjust the program slightly during treatment.

How do I adjust the motorized intramedullary nail?

To adjust this internal fixator, all you need to do is hold the remote control over the limb at set times. This will send a signal to the nail to lengthen a certain amount according to the program. Your child’s limb reconstruction team will teach you how to do this.

Does my child need to take special care with the motorized intramedullary nail?

Your child will need crutches to help them walk, as they will not be able to put all their weight on the limb while it is lengthening.

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Last updated: August 31st 2015