The GAP NailTM Endo-Exo Medullary System

The unique locking nail for small medullary canal patients

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The Gap endo-exo medullary systemTM consists of an intramedullary nail linked to a lateral buttress plate, via lag and mechanical screws, creating a combined Endomedullary / Exomedullary osteosythesis device. This novel approach of osteosynthesis creates a load sharing system between the nail and plate, thus limiting the risk of stress fractures and improving the implant stability in weak bones.

Intended Use

The Gap endo-exo medullary system is used for the treatment of fractures or correction of deformities in the femur, tibia and humerus of pediatric patients, who have reached skeletal maturity. Indications include:

  • Correction of deformities (OI, skeletal dysplasia, coxa vara, coxa valga)
  • Diaphyseal fracture of the femur, tibia and humerus
  • Subtrochanteric, intertrochanteric and combination fractures of the femoral neck.
  • Nonunions and malunions


  • Available sizes range from Ø4.8 to 8.0 mm
  • Endo/Exo hyperstatic system designed to improve load distribution
  • Plate offers support to greater trochanter
  • Coxa vara plate (guidance of k-wires and support of osteotomy)
  • Instrumentation allows for guided distal fixation and precise measurement of anteversion/derotation correction
  • Precise and simple surgical technique

Surgical Technique Animation

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