Orthopedic nails for intramedullary fixation Orthopedic nails are intramedullary implants used in long bone, minimally invasive reconstruction surgeries for fixing bone fractures resulting from trauma or osteoporosis. Most orthopedic nail systems use bolts to “lock” the nail into position on both ends of the fracture. Advanced intramedullary fixation systems use expandable nails that do not require interlocking screws. The orthopedic surgeon inserts the nail in its reduced form through the medullary canal and pushes it into position. Then, the surgeon pumps saline solution into the hermetically sealed nail. As the liquid pressure increases, the nail expands to the desired diameter in a controlled manner.