Intramedullary nailing puts the implant inside the bone, on the mechanical axis, where it shares load with the cortex instead of carrying all of it from the outside. Peak Surgicals supplies nine nailing instrument sets covering tibia, femur, humerus, elastic nailing and nail removal, from 23 to 47 pieces, in German stainless steel and CE marked and built under ISO 13485. Compare the full range in the grid below.
Finding a Hole You Cannot See
Everything in a nailing set exists because the surgeon cannot see the canal. Entry is made at a defined point, the canal is reamed to a diameter matched to the implant, the nail is driven, and locking screws are then placed through holes that are somewhere inside the bone. Finding those holes is the central problem of the operation.
The targeting device answers it. Mounted to the nail before insertion, it holds a fixed geometric relationship to the locking holes, so the drill sleeve it carries points at a hole nobody is looking at. The alternative is freehand technique under image intensification, which works but costs radiation time for everyone in the room. The rest of the set supports that sequence: reamers, guide wires, drill sleeves, depth gauges, screwdrivers and the impactor that drives the nail without deforming its proximal end.
Tibia, Femur and Humerus
Anatomy separates the sets. Tibia Intramedullary Nail Instrument Set (PS-NTINIS-00128, 47 pieces, $1,979.99) and Tibial Intramedullary Nail Instrument Set (PS-TINIS-00130, 34 pieces, $2,308.90) cover tibial nailing, where proximal locking passes through cancellous bone that gives less purchase than cortex. Femur Intramedullary Nail Instrument Set (PS-FINIS-00123, 35 pieces, $2,365.00) covers femoral shaft work.
Proximal femoral fixation runs differently again, because the screws pass up the neck into the head rather than across the shaft. Reversed Femoral Gamma Intramedullary Nail Instrument Set (PS-RFGINIS-00129, 28 pieces, $2,088.90) and the two Femoral Reconstruction sets ($2,088.90 and $2,365.00) carry that cephalomedullary instrumentation, where targeting has to be accurate in two planes at once. Humeral Interlocking Nail Instrument Set (PS-HINIS-00125, 29 pieces, $1,320.00) covers the upper limb.
Elastic Nailing and Removal
Elastic nailing works on a different principle entirely. Instead of one rigid implant filling the canal, two or more flexible nails are passed from either side and pre-bent so they bear against the cortex at three points, holding the fracture by elastic tension rather than by rigid fixation. That is what allows it in children: the nails enter away from the growth plate and are removed once union is achieved. Elastic Nail Instrument Set (PS-ENIS-00121, $658.90) carries that instrumentation, and it is priced accordingly because the sequence needs fewer instruments than a locked nailing set.
Removal is its own problem. A nail that has been in place through union is no longer loose in a canal: bone has grown around it, locking screws may be seized, and the extraction thread may be filled with tissue. Intramedullary Nail Removal Set (PS-INRS-00126, 23 pieces, $2,088.90) carries the multi-chuck extraction system, hooks and slotted hammer for those conditions. Insertion instruments advance a nail along a prepared path; extraction instruments break a bond and pull against resistance that was not there going in.
Material, Reprocessing and Certification
Every instrument is manufactured from German stainless steel and passivated for corrosion resistance across repeated cycles. On sets this size the inspection is done by function rather than item by item: check reamer flutes and drill bits under magnification for chipping, because a dull cutting edge generates heat in a canal that cannot dissipate it; sight down every guide wire, drill sleeve and targeting arm against a straight edge, since a bent targeting arm points the sleeve at the wrong place and the error stays invisible until the drill misses; and work every chuck, coupling and screwdriver through full travel to confirm it engages and releases cleanly. Clean immediately with a neutral-pH enzymatic solution, flushing all cannulated components and brushing bone debris from flutes before it dries, then rinse with deionised water and dry fully, following the reprocessing instructions supplied.
These are Class I reusable instruments, supplied non-sterile, CE marked and built under ISO 13485, with a one-year manufacturing warranty. We ship at MOQ 1 with free shipping over $99, and OEM production is available for distributors. See Orthopedic External Fixation Sets for temporising fixation, or browse all Orthopedic Instruments.
