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Hardware: What is exchange nailing?

This is an operation during which the original intramedullary nail is removed and exhanged for a larger diameter implant. The reason for this would be nonunion of the original fractured bone.
The exchange does two things
a) improves the fixation at the fracture site so the fragments are held still.
b) reaming the inside of the bone produces ground up bone fragments which act like bone graft and promote healing.
It sounds as if it will be horribly painful. It shouldn't be because all the grinding etc is done while you are asleep. After the surgery you will have the normal post-op pain at the wound but the bone itself may be less sore than it is now. (less movement at the fracture site)
The operation should advance your recovery time because you have to do something about a nonunion. Xray should be able to tell within 6 - 12 weeks if it has made a difference to healing of the bone. If the bone does heal you still have 3 months before it is 80% of normal strength and 18 months before things stop improving.

Myles Clough MD OS Jan 3 2002


From: Kellie

There is the posibility that I might have to go though this. How long is the recovery time? I do not feel any pain at this "break" sight, I have a muscle and skin gragh at the same area, all in the lower leg. I was told I could keep all my "hardware" at first. My injuries are about 8 months old now. I have a rod in the femur also. 3 screws were removed 3 weeks ago to hopefully help stimulate the lower bone. I have more pain in the knee area now, is that due to "the bone bleeds from having the screws removed"? Thankyou for your help.


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