Intramedullary nail for long bone

Abstract

An intramedullary nail (1) for long bones, comprising: a tube (2) extending in an axial direction of the intramedullary nail (1), the tube (2) comprising a first through slot (21) aligned longitudinally in the axial direction; a first rod (3) extending in the axial direction and telescopically coupled within the tube (2), the first rod (3) further configured for axial displacement within the tube (2). The first rod (3) comprises a first hole (31) perpendicular to the axial direction and configured for receiving a first fastening screw (100), the first hole (31) being configured for axial displacement along the first through slot (21) to displace the first fastening screw (100) in the axial direction. The first rod (3) further comprises: a second hole (32) perpendicular to the axial direction; a guide element (5) housed in the second bore (32) and axially displaceable in the axial direction, the guide element (5) being enclosed within the outer contour of the tube (2) and configured for preventing a relative rotation of the first rod (3) with respect to the tube (2). (Figure 5)

Description

Intramedullary nails for long bones Technical Field

[0001] This invention relates to the general technical field of orthopedics. More specifically, this invention relates to an intramedullary nail for long bones.

[0002] The intramedullary nail according to the invention enables bone transport in long bones, involving the lengthening of long bones or arthroplasty, without the use of external fixators. Background Technology

[0003] Intramedullary nails are known from existing technologies to be able to pull long bones in various ways, depending on the specific orthopedic application.

[0004] For example, two bone fragments can be displaced relative to each other using an intramedullary nail that includes a actuator. At the point of contact between the two bone fragments, the bone is designed to regrow.

[0005] Intramedullary nails are particularly suitable for treating long bones, including: the femur (thigh bone) and tibia (shin bone), the humerus (upper arm bone), the ulna (forearm bone), the radius, and the fibula.

[0006] With proper preoperative planning, intramedullary nailing makes it possible to provide axial and torsional correction as part of limb lengthening.

[0007] Document WO2021032823 (A1) relates to an intramedullary nail for traction of long bones, comprising: a first tube extending in the axial direction of the intramedullary nail, a second tube extending in the axial direction of the intramedullary nail and coupled to the first tube for axial displacement within each other, a first locking opening in an end region of the first tube remote from the second tube, and a coil for energizing an actuator.

[0008] Unfortunately, known intramedullary nails are not entirely effective in treating certain conditions.

[0009] For example, when there is significant bone loss, such as a length of more than 2-3 cm between the proximal and distal bone segments, it is biologically not permissible to bring the two bone stumps into contact by shortening the limb and then performing callus traction.

[0010] In particular, in known intramedullary nails, the maximum elongation that can be provided to long bones is limited by the displacement of the fixation screw inserted into a hole that moves along a groove on the body of the intramedullary nail. Once the fixation screw reaches the end of such a groove, further displacement is not possible.

[0011] If the intramedullary nail cannot provide sufficient lengthening for the long bone, it is necessary to further lengthen the long bone by replacing the previous intramedullary nail and implanting a new one to complete the surgery.

[0012] Furthermore, operating the actuator of an intramedullary nail without a corresponding pin in the slot is risky, as the inner rod may rotate within the tubular body and the hole for securing the screw may become inaccessible. Summary of the Invention

[0013] A general objective of this invention is to overcome the shortcomings of the prior art.

[0014] A specific object of the present invention is to provide a more effective intramedullary nail for long bones.

[0015] Another specific object of the present invention is to provide an intramedullary nail for long bones that allows for more efficient bone transport, particularly for bone lengthening.

[0016] Another specific object of the present invention is to provide an intramedullary nail for long bones that can be better used to correct various bone defects.

[0017] Another specific object of the present invention is to provide an intramedullary nail for long bones that is more reliable in terms of displacement rods and transport fixation screws within the tubular body.

[0018] These and other purposes are achieved through an intramedullary nail used for long bones.

[0019] The intramedullary nail includes a tube extending in an axial direction, the tube including a first through slot aligned longitudinally in the axial direction.

[0020] The intramedullary nail includes a first rod that extends axially and is telescopically coupled within the tube; the first rod is configured for axial displacement within the tube.

[0021] The first rod includes a first hole perpendicular to the axial direction and configured to receive a first fixing screw.

[0022] The first hole is configured for axial displacement along the first through slot to displace the first fixing screw.

[0023] The first rod also includes a second hole perpendicular to the axial direction.

[0024] The first rod also includes a guide element housed in the second hole and capable of axial displacement in the axial direction.

[0025] The guiding element is enclosed within the outer contour of the tube and configured to prevent relative rotation of the first rod with respect to the tube.

[0026] Advantageously, the guiding element constrains the rotation of the first rod within the tube, thereby keeping the first hole within the profile of the first through slot even during actuator activation.

[0027] Advantageously, the smaller guiding element remains within the volume defined by the tube of the intramedullary nail.

[0028] In particular, advantageously, the guiding element does not protrude beyond the body of the tube defined by the outer contour of the first through groove, so that the guiding element does not interfere with the surrounding tissue during axial displacement, thereby improving the tolerance of the implant.

[0029] Furthermore, advantageously, even after the fixation screw is removed from the first hole, the guiding element allows for axial displacement of the first rod within the tube. This enables a “recharge” (supplement) of the traction displacement provided by the intramedullary nail. Specifically, when the intramedullary nail reaches its maximum displacement but further bone transport is required for bone lengthening, the fixation screw can be temporarily removed from the first hole and the actuator activated to displace the rod in the opposite axial direction. The fixation screw is then reinserted into the first hole, secured in the new bone segment, and transport can continue using the same intramedullary nail to achieve the desired lengthening.

[0030] Advantageously, the guide element allows for reverse displacement of the rod in the axial direction without rotation of the rod within the body, which could prevent the fixing screw from approaching the first hole.

[0031] Furthermore, advantageously, the guide element does not protrude beyond the outer contour of the first through groove, so that the guide element does not interfere with the surrounding tissue during reverse axial displacement, thus avoiding excessive damage to the surrounding tissue during further surgical follow-up.

[0032] Preferably, the guiding element includes a threaded guide screw inserted into the second hole, which can be quickly unscrewed and removed from it.

[0033] Other features and advantages will become more apparent from the following detailed description of preferred, non-limiting embodiments of the invention and from the dependent claims that outline preferred and particularly advantageous embodiments of the invention. Attached Figure Description

[0034] This invention will be described with reference to the following drawings, which are provided by way of non-limiting example, wherein:

[0035] Figure 1 shows a top view of a preferred embodiment of an intramedullary nail for long bones according to the present invention.

[0036] Figure 2 shows a partial view of the intramedullary nail of Figure 1 in the disassembly configuration.

[0037] Figure 3 shows a partial lateral cross-sectional view of the intramedullary nail of Figure 1 in its first through-channel region, as well as the guide element for disassembly.

[0038] Figure 4 shows a view corresponding to Figure 3, with the assembled guide elements.

[0039] Figure 5 shows a three-dimensional view of the intramedullary nail in Figure 1.

[0040] Figure 6 shows a cross-sectional view of the intramedullary nail of Figure 1 with three fixing screws.

[0041] Figure 7 shows another perspective view of the intramedullary nail of Figure 1 with fixing screws.

[0042] Figure 8 shows the first application of the intramedullary nail of Figure 1 in a long bone.

[0043] Figure 9 shows a second application of the intramedullary nail from Figure 1 across the knee joint.

[0044] In different drawings, similar components will be identified with similar reference numbers.

[0045] Furthermore, in the figure, if there are multiple elements that are similar to each other, only one (or only some) will be indicated by reference numerals for clarity; other similar elements, although not indicated by appropriate reference numerals, should be understood to be included by analogy. Detailed Implementation

[0046] A preferred, and in any case non-limiting, embodiment of the intramedullary nail 1 for long bones according to the invention is shown in FIG1.

[0047] The intramedullary nail 1 includes (but is not limited to) a tube 2 extending in the axial direction of the intramedullary nail 1.

[0048] The tube 2 includes a hollow shell, as will be further described below, and includes a first through groove 21 longitudinally aligned in the axial direction.

[0049] The terms "axial" and "radial" in this document should be understood relative to the longitudinal axis of the intramedullary nail 1, which in particular extends along the intramedullary nail 1 or its maximum spatial extension. Specifically, the axial direction should be understood as a direction along or parallel to the longitudinal axis of the intramedullary nail 1, and the radial direction should be understood as a direction perpendicular to the longitudinal axis. The longitudinal axis of the intramedullary nail 1 may also be curved, for example, in an intramedullary nail 1 with a slight curve for the lower leg. Typically, the intramedullary nail 1 is at least substantially circular in a cross-section perpendicular to its longitudinal axis.

[0050] As will be further described below, the intramedullary nail 1 can be coupled to a receiver (not shown) connected via a power feeder. External control electronics (not shown) and a transmitter (not shown) may be provided. The energy required for the actuator is transmitted to the receiver implanted under the skin via the applied transmitter, so there is no contact between the implanted intramedullary nail 1 and the body surface (skin).

[0051] Intramedullary nails enable bone transport, lengthening, or arthrodesis in long bones without the need for external fixators. With proper preoperative planning, axial and torsional corrections can be performed during limb lengthening.

[0052] Preferably, the intramedullary nail 1 comprises two or more interconnecting elements that can be assembled, welded together, bonded together, or shaped and closed together using a connection process. In possible variations, the tube 2 may also comprise two or more tubular components.

[0053] Typically, tube 2 is made of metal or metal alloy, especially of biocompatible metal or biocompatible metal alloy.

[0054] Preferably, some elements of the intramedullary nail 1 are made of plastic, such as epoxy resin, silicone or thermoplastic resin.

[0055] Figure 2 shows a partial view of the intramedullary nail 1 in the disassembly configuration.

[0056] The intramedullary nail 1 includes a first rod 3 extending in the same axial direction and telescopically coupled within the tube 2. As will be further described below, the first rod 3 is configured for axial displacement within the tube 2.

[0057] The tube 2 with the first through groove 21 provides mounting for the telescopic rod 3. In particular, the first through groove 21 has the function of axially restraining the displacement of the rod 3 in the presence of a protrusion (e.g., a bone fixation screw (not shown)).

[0058] The first rod 3 includes a first hole 31 perpendicular to the axial direction and configured to receive a first fixing screw (not shown). The first hole 31 formed in the first rod 3 is also configured for axial displacement along the first through groove 21 to displace the first fixing screw for moving bone segments, particularly for lengthening long bones, as will be further described below.

[0059] The first rod 3 also includes a second hole 32 perpendicular to the axial direction.

[0060] In a preferred, non-limiting embodiment, the second hole 32 is aligned parallel to the first hole 31. However, the second hole 32 may be non-parallel, as long as it remains configured to move along a groove oriented in the same axial direction. For example, the second hole 32 may be tilted 90° and move along a second, different groove also oriented at 90°. The purpose of the second hole 32 will be further described below.

[0061] The intramedullary nail 1 includes an actuator 4 configured for axial displacement of a first rod 3 within a tube 2. Preferably, the actuator 4 includes an electric motor 41 and a helical drive 42. The electric motor 41 is adapted to power the helical drive 42, which in turn acts on the first rod 3 to achieve its reversible displacement.

[0062] Typically, once the intramedullary nail 1 is implanted, it is preferably powered by an external controller that transmits electrical pulses through the skin to a subcutaneously implanted antenna. Energy is then transmitted via power line 43 to the electric motor 41 of the intramedullary nail 1. The electric motor 41, preferably via a gear reduction system, provides rotational motion to a worm gear 42, which has a first rod 3 containing a first hole 31 for a transfer section.

[0063] Preferably, the intramedullary nail 1 includes a power supply device (not shown) for supplying power to the driver 4 via a power line 43. Preferably, this power supply device includes an induction coil.

[0064] Preferably, the intramedullary nail 1 and the primary coil connected to the power line 43 are configured for transcutaneous data transmission with another external coil. Preferably, the intramedullary nail 1 includes a data processing unit for transmitting data through the coil or for reading data received through the coil.

[0065] In possible variations, the drive may include a gear transmission, an electronic system and / or sensor system for controlling and monitoring the drive, and an energy storage device (such as a battery).

[0066] In other possible variations, the drive may include different kinds of transmission / motor systems that are not necessarily electric, such as those involving manual operation.

[0067] Figure 3 shows a partial lateral cross-sectional view of the intramedullary nail 1 in the region of the first through-slot 21, while Figure 4 shows a view corresponding to Figure 3 with the assembled guide element, which will be described further below.

[0068] As shown in the cross-sectional line, the first rod 3 is preferably made of one or more components assembled together.

[0069] The first rod 3 includes a guide element 5 that can be accommodated in the second hole 32. In Figure 3, the guide element 5 is separated from the first rod 3, while in Figure 4, the guide element 5 is coupled to the first rod 3, as under operating conditions.

[0070] The guide element 5 is axially displaceable because it is coupled to the axially displaceable first rod 3.

[0071] Preferably, the guide element 5 is displaced along the same first through slot 21 as described above. In possible variations, the guide element 5 and its associated second hole 32 may be provided together with a dedicated slot, separate from the slot 21 but oriented in the same axial direction.

[0072] The guide element 5 remains enclosed within the outer contour of the first through groove 21 and is configured to prevent relative rotation of the first rod 3 relative to the tube 2.

[0073] The second hole 32 can be a through hole or a blind hole.

[0074] The second hole 32 that accommodates the guide element 5 is preferably threaded, and the guide element 5 is preferably a guide screw that includes a threaded rod 51 screwed into the second hole 32.

[0075] Preferably, the guide screw 5 also includes a head 52, which remains closed within the outer contour of the tube 2 during axial displacement so as not to protrude beyond the tube 2 itself.

[0076] Since the guide screw 5 can be unscrewed and removed from the second hole 32, the guide element can be removed quickly. Therefore, if a little "additional" displacement is desired, the guide screw 5 can be removed and the entire length of the groove 21 can be displaced until the retaining screw 100 contacts the end of the first groove 21 and the second hole 32 extends beyond the end of the first groove 21 inside the tube 2.

[0077] In possible variations, instead of screws, the guide element may include different elements that can be accommodated in the second hole 32, such as adhesive or otherwise constrained inserts. Similarly, the second hole does not need to be circular and can have various shapes, even more complex ones.

[0078] As can be seen from the cross-sectional view, the tube 2 includes a hollow shell, and the first through slot 21 includes two corresponding cuts 21a and 21b in the hollow shell; the two corresponding cuts 21a and 21b are laterally aligned with each other to provide the through slot 21. In a preferred embodiment, the hollow shell of the tube 2 is cylindrical or substantially cylindrical; in possible variations, the hollow shell may define a polygonal profile.

[0079] Figure 5 shows a perspective view of the intramedullary nail 1, while Figure 6 shows a cross-sectional view of the intramedullary nail 1 with fixation screws 100, 100b (in a longer variant), which will be described further below.

[0080] The first rod 3 includes a first end 30 that is axially displaceable within the tube 2. Preferably, the second hole 32 is closer to the first end 30 than the first hole 31. In possible variations, the positions of the second hole 32 and the first hole 31 can be interchanged, or they can even be aligned at the same axial position if two separate axial slots are provided.

[0081] Preferably, in a non-limiting embodiment, the first hole 31 is adjacent to the second hole 32.

[0082] Preferably, in some embodiments, the first hole 31 and the second hole 32 of the first rod 3 are configured to remain within the contour of the first through slot 21 during the latter's axial displacement.

[0083] Preferably, the tube 2 further includes a distal portion 60, which includes at least one fourth hole 61 configured to receive a third fixing screw 100b.

[0084] Preferably, the distal portion 60 further includes a second through slot 22. Preferably, the second through slot 22 is longitudinally aligned in the axial direction and aligned with the first through slot 21. Alternatively, the second through slot may not be aligned with the first through slot, provided that the principal axial dimension of the second slot is aligned with the longitudinal axis of the first slot.

[0085] Preferably, the distal portion 60 further includes a second rod 62 that extends in the axial direction and is telescopically coupled within the tube 2.

[0086] Preferably, the second rod 62 is configured for axial displacement within the tube 2, and the second rod 62 includes at least one fourth hole 61; in the example there are three holes 61 (only one is shown in Figures 5 and 6).

[0087] At least one fourth hole 61 is configured for axial displacement along the second through slot 22 to displace the third fixing screw for further movement of bone segments and, if necessary, lengthening of long bones.

[0088] Preferably, the second rod 62 is adapted to extend beyond the axial length of the tube 2 by its movable end 63 if necessary during the elongation of the long bone.

[0089] Specifically, during its displacement, the first rod 3 does not contact the second rod 62. In other words, the second rod 62 is configured for free axial displacement within the tube 2, constrained only by a fixing screw inserted into at least one fourth hole 61.

[0090] In possible variations, at least one fourth hole 62 may be tilted (or skewed) in the axial direction, and thus tilted relative to the first hole 31.

[0091] Preferably, in the intramedullary nail 1, holes 31 and 61 are oriented in the radial direction.

[0092] Preferably, two or more locking holes are oriented parallel to each other.

[0093] Preferably, the second rod 62 includes a second guide element 63 that is received in a corresponding hole and is axially displaceable in the axial direction.

[0094] The guide element 63 remains enclosed within the outer contour of the second through slot 22 and is configured to prevent relative rotation of the second rod 62 relative to the tube 2.

[0095] The guide element 63 constrains the rotation of the second rod 62 within the tube 2, thereby keeping at least one fourth hole 61 within the profile of the second through slot even during actuator activation.

[0096] Advantageously, the guiding element 63 is held within the volume defined by the tube 2 of the intramedullary nail 1.

[0097] In particular, advantageously, the guide element 63 does not protrude beyond the body of the tube 2 defined by the outer contour of the second channel 22, so that the guide element 63 does not interfere with the surrounding tissue during axial displacement, thereby improving the tolerance of the implant.

[0098] The hole for receiving the guide element 63 is preferably threaded, and the guide element 63 is preferably a guide screw comprising a threaded rod screwed into the corresponding hole.

[0099] Figure 7 shows another perspective view of the intramedullary nail 1 with fixation screw 100.

[0100] As described above, the first rod 3 includes a first hole 31 perpendicular to the axial direction and configured to receive a first fixing screw 100.

[0101] The first hole 31 is configured for axial displacement along the first through slot 21 to displace the first fixing screw 100 in order to move the bone segment and achieve the planned treatment, such as for lengthening a long bone.

[0102] The fixation screws are configured to lock the various elements of the intramedullary nail 1 into the bone fragments of the long bone; in this way, the intramedullary nail can be attached to the bone fragments of the long bone to be fixed in all directions and all rotational directions. Therefore, the intramedullary nail 1 can be fixedly attached to the bone fragments in all degrees of freedom.

[0103] As previously stated, even without the fixing screw 100, the guiding element 5 remains enclosed within the outer contour of the first through groove 21 and prevents relative rotation of the first rod 3 relative to the tube 2, thereby enabling displacement of the rod 3, particularly reverse displacement, to "recharge" the traction capacity. This "recharge" feature becomes particularly advantageous when further bone lengthening is required and the fixing screw 100 has reached the end of the first through groove 21.

[0104] Advantageously, the guiding element 5 constrains the rotation of the first rod 3 within the tube 2, thereby keeping the first hole 31 always within the contour of the first through slot 21 so that it can be further approached at any time with the fixing screw 100, even after reverse displacement.

[0105] The intramedullary nail 1 preferably also includes a proximal portion 40.

[0106] In a preferred embodiment, the proximal portion 40 surrounds the driver 4; in possible variations, the driver may be positioned in different locations, such as the distal end.

[0107] The proximal portion 40 includes at least one third hole 44 perpendicular to the axial direction. Preferably, the third hole is aligned parallel to the first hole 31. At least one third hole 44 is also configured to receive a second fixing screw (not shown). Preferably, the third hole 44 is held in place within the body of the intramedullary nail 1.

[0108] Figure 8 shows an intramedullary nail 1 applied to a long bone 1000 with associated bone defects that requires lengthening.

[0109] In this example, the length of bone 1000 is initially maintained by stabilizing the upper and lower parts of the bone to intramedullary nail 1 using screws 100a and 100b.

[0110] Osteotomy is performed near the site of greatest bioactivity in the missing bone fragment 2000, thereby defining the removable bone fragment.

[0111] The obtained bone segment is stabilized in the central sliding portion of the intramedullary nail 1 by another fixing screw or "pin" 100, and connected to the first through groove 21 where the first rod 3 is displaced.

[0112] Carried by pin 100, the bone segment is axially moved until it comes into contact with and abuts against a more distant distal bone fragment.

[0113] Therefore, the intramedullary nail 1 is configured to move the bone segment until it meets the distal portion, as indicated by the two parallel arrows.

[0114] When the transported bone segment carried by pin 100 contacts the distal bone fragment, the distal portion 60 of pin 1 includes the aforementioned second rod 62, which allows for further displacement together with the first rod 3 and its associated first through groove 21, allowing for further elongation of the long bone 1000.

[0115] In some cases, the displacement provided by the intramedullary nail 1 may be insufficient, for example, because it is not possible to implant a sufficiently long intramedullary nail in the long bone of a particular patient.

[0116] In this case, to achieve further displacement, pin 100 can be removed from the bone segment, and the driver retraction rod 3 and the associated first hole 31 can be used.

[0117] Once the rod retracts to the "recharge (replenish)" position, pin 100 (or its alternative) can be inserted into different positions on the bone segment to continue its displacement, achieving further extension of bone 1000.

[0118] In other words, for bone lengthening, if the stroke provided by the first rod 3 is insufficient, for example due to the size of the long bone or the intramedullary nail, the transfer pin 100 can be removed, and the rod 3 can be returned to a more retracted position in a controlled manner in the presence of the guide element 5. Lengthening can then be restored by reinserting the pin 100 without removing the intramedullary nail 1 from the bone 1000.

[0119] Figure 9 illustrates a second application of the intramedullary nail of Figure 1 across the knee joint, which includes two long bones (femur 1001a and tibia 1001b, respectively).

[0120] For knee fusion applications, the distal portion of the femur 1001a or the femur 1001a itself is moved to the tibial plateau of the tibia 1001b by displacement within the first through groove 21 via the first rod 3 and the associated pin 100.

[0121] In this application, pin 100b engages in the distal portion 60 in a manner that prevents it from sliding in the second through groove 22. In this way, the position of the tibia 1001b is constrained by pin 100b, and bone lengthening of the femur can be provided, for example, to restore the gap created by the removal of the knee prosthesis.

[0122] In light of the above description, those skilled in the art will be able to design further modifications and variations to meet incidental and specific requirements.

[0123] For example, the size of an intramedullary nail can vary, especially its length, so it can be used for different applications.

[0124] Therefore, the embodiments described herein should be considered as illustrative and non-limiting examples of the invention.

Claims

1. An intramedullary nail (1) for long bones, comprising: A tube (2) extending along the axial direction of the intramedullary nail (1), the tube (2) including a first through groove (21) longitudinally aligned along the axial direction; a first rod (3) extending along the axial direction and telescopically coupled within the tube (2), the first rod (3) further configured for axial displacement within the tube (2), wherein the first rod (3) includes a first hole (31) perpendicular to the axial direction and configured to receive a first fixing screw (100), the first hole (31) being configured for axial displacement along the first through groove (21) to displace the first fixing screw (100) in the axial direction; characterized in that the first rod (3) further includes: a second hole (32) perpendicular to the axial direction; a guide element (5) received in the second hole (32) and capable of axial displacement along the axial direction, the guide element (5) being enclosed within the outer contour of the tube (2) and configured to prevent relative rotation of the first rod (3) relative to the tube (2).

2. The intramedullary nail (1) according to claim 1, wherein, The second hole (32) is threaded, wherein the guide element (5) is a guide screw comprising a threaded rod (51) and a head (52), wherein the threaded rod (51) is screwed into the second hole (32), and wherein the head (52) remains closed within the outer contour during axial displacement so as not to protrude outside the tube (2).

3. The intramedullary nail according to claim 1 or 2, wherein, The first rod (3) includes a first end (30) that is axially displaceable within the tube (2), and the second hole (32) is closer to the first end (30) than the first hole (31). The first hole (31) is preferably adjacent to the second hole (32).

4. The intramedullary nail according to any one of claims 1 to 3, further comprising an actuator (4) configured to axially displace the first rod (3) within the tube (2).

5. The intramedullary nail according to claim 4, wherein, The driver (4) includes an electric motor (41) and a screw drive (42), wherein the electric motor (41) supplies power to the screw drive (42), and the screw drive (42) acts on the first rod (3) to achieve reversible displacement.

6. The intramedullary nail according to claim 4 or 5, further comprising a proximal portion (40) surrounding the actuator (4), wherein, The proximal portion (40) further includes at least one third hole (44) perpendicular to the axial direction, the at least one third hole (44) being configured to receive a second fixing screw.

7. The intramedullary nail according to claim 6, wherein, The third hole (44) is fixed in the body of the intramedullary nail (1).

8. The intramedullary nail according to any one of claims 4 to 7, further comprising a power supply device for powering the actuator (4), preferably the power supply device comprising an induction coil.

9. The intramedullary nail according to any one of claims 1 to 8, wherein, The tube (2) further includes a distal portion (60), which further includes at least one fourth hole (61) configured to receive a third fixing screw.

10. The intramedullary nail according to claim 9, wherein, The distal portion (60) further includes a second through groove (22) longitudinally aligned along the axial direction, and the distal portion (60) further includes a second rod (62) extending along the axial direction and telescopically coupled within the tube (2), the second rod (62) being further configured for axial displacement within the tube (2), the second rod (62) including the at least one fourth hole (61), the at least one fourth hole (61) being configured for axial displacement along the second through groove (22) to further move the third fixing screw.

11. The intramedullary nail according to claim 10, wherein, The second rod (62) further includes a second guide element (63) housed in a hole perpendicular to the axial direction, the second guide element (63) being axially displaceable along the axial direction and enclosed within the outer contour of the tube (2), and configured to prevent relative rotation of the second rod (62) relative to the tube (2).

12. The intramedullary nail according to any one of claims 9 to 11, wherein, The at least one fourth hole (61) is inclined in the axial direction and relative to the first hole (31).

13. The intramedullary nail according to any one of claims 1 to 12, wherein, The first hole (31) and the second hole (32) are configured to remain within the contour of the first through groove (21) during the axial displacement.

14. The intramedullary nail according to any one of claims 1 to 13, wherein, The tube (2) includes a hollow shell, and wherein the first through groove (21) includes two corresponding cuts (21a, 21b) in the hollow shell, the two corresponding cuts (21a, 21b) being laterally aligned with each other.

15. The intramedullary nail according to any one of claims 1 to 14, wherein, The guide element (5) is configured to constrain the rotation of the first rod (3) within the tube (2), thereby keeping the first hole (31) within the contour of the first through slot (21).

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