An intramedullary nail fastener targeting and bone compression/distraction device provides bone fastener alignment and compression or distraction of the bone. The intramedullary nail fastener targeting and bone compression/distraction device has a nail carrier portion, a bone fastener alignment and drill jig portion, and a compression/distraction mechanism. Various sizes of intramedullary nails are retained by the device while alignment carriages provides for proper drilling of the bone and placement of bone fasteners such as screws. The compression/distraction mechanism provides measured compression or distraction of the bone prior to final bone fastener placement.
