Tibial nailing is related with relatively low incidence of nonunion, malunion, infection and compartmental syndrome 911. In fractures within 30 mm of the plafond robinson shortened the nail to enable the placement of two inter. The titanium tibial nail system surgical technique 15 inserting the nail assemble the insertion instruments orient the insertion handle anteriorly, and match the flats on the handle and nail. Trigen humeral nail proximal and long trigen hindfoot nail. When selecting the appropriate nail size take all aspects of the fracture into consideration.
If the offset driver handle should loosen slightly during insertion, tighten it down before continuing. Intramedullary im nailing is the preferred method of treatment for tibial stress fractures because of. You may remove your bandage 5 days after surgery except the steristrips on the skin, if you have them. Rehabilitation following bilateral tibial intramedullary nail placement in an elite athlete sharon young abney, spt. Dec 01, 2008 we compared reamed and unreamed intramedullary nailing with regard to the rates of reoperations and complications in patients with tibial shaft fractures. Extending the indications of intramedullary nailing with the. Trigen meta nail retrograde femoral nail is indicated for fractures of the femur including stable and unstable distal metaphyseal fractures. Pdf fatigue strength of common tibial intramedullary. Trigen metanail instrumentation bmt medical devices.
Relevant information on publication year, type of the study, patient demographics, type of fracture open or closed, time interval from fracture to intramedullary nailing fixation, duration of follow up, type of bacteria isolated, and method of treatment following intramedullary infection were carefully extracted. Ao percutaneous iliosacral screw insertion, supine upper sacral segment duration. Shaft fractures with associated tibial plateau or pilon fractures requiring tibial plating in addition to the nail were excluded from the study. The proximal tibiofibular joint was analyzed in 30 patients, who reported knee pain after tibial nailing, and standard radiograph and computed tomography were performed to examine the proximal third of the tibia.
Freedman and johnson 2 reported malalignment defined as a. Utilizing the same trigen instruments, the tan was developed to simplify the surgical approach by. Reduced flexion leads to less pull from the quadriceps muscle, helping to avoid fracture malreductions and malalignment. Trigen intramedullary nailing system trigen sureshot distal targeting system trigen meta nail retrograde femoral nail trigen meta nail tibial nail trigen meta nail nailing in extension instrumentation trigen fan femoral antegrade nails trigen tan trochanteric nails trigen intertan intertrochanteric antegrade nail trigen hindfoot fusion nail trigen humeral nail with. Mar 02, 2017 ao percutaneous iliosacral screw insertion, supine upper sacral segment duration. In the final analysis, the preferred treatment is that. Concerns regarding bony union have been reported in medical literature, but no case of femoral nail breakage secondary to delayed union has been reported to date. Hold a sterile expert tibial nail on the lateral side of the lower leg with its distal end parallel to the tibia shaft.
There are a full range of sizes for a comprehensive approach to the treatment of femoral fractures. When treating distal tibia fractures with a tibial nail, stresses are increased on the nails distal portion. Rehabilitation following bilateral tibial intramedullary nail. Drive the nail until the proximal end is even with the tip of the greater trochanter. Jul 01, 2011 in the absence of special techniques to achieve and maintain accurate reduction, extraarticular proximal third tibial fractures treated with an intramedullary nail will commonly be malreduced in. Phoenix tibial nail system featuring corelocktm technology. One implant, two approaches stryker has created a next generation locking nail system, bringing together all the capabilities and benefits of. Tibia intramedullary nail postop instructions wound care bathing.
In 1958, the ao formulated four basic principles, which have become the guidelines for internal fixation in general,1. Tibial nails have locking screw holes close to both ends, in multiple orientations, for better fixation of proximal and distal fractures. The trigen meta nail tibial nail is indicated for fractures of the proximal and distal third of the tibia, including the shaft, stable and unstable fractures, nonunions, malunions, and for the prophylactic nailing of impending pathological fractures. Recommendations for avoiding knee pain after intramedullary. The cannulated tibial nail ctn is intended to stabilize fractures of the tibia.
Scribd is the worlds largest social reading and publishing site. Deborah michael wendland, pt, dpt, phd, cped mercer university atlanta, ga abstract background. Intramedullary im nailing is the preferred method of treatment for tibial. These line additions are comprised of retrograde femoral, supracondylar, and tibial intramedullary nails and a nail cap. Phoenix tibial nail system the phoenix tibial nail system is indicated for alignment, stabilization, and fixation of fractures caused by trauma or disease, and the fixation of long bones that have been surgically prepared osteotomy for correction of deformity and for arthrodesis. Download download trigen humeral nail surgical technique pdf writer read online read online trigen humeral nail surgical technique pdf writer official fulltext paper pdf. Agathangelidis f et al in vitro study showed that, when using the expert tibial nail for unstable distal tibial fractures, the classic configuration of two parallel distal screws could provide the. The trigen tan is used for the same indications as the standard trigen fan. All intertan nail templates are available with 117% magnification to compensate for radiographic magnification. Please keep in mind that variations in magnification do occur.
Russell, md, mba university of mississippi medical center treatment goals shaft fracture. Enhanced fixation dedicated instruments for blocking screws and extension nailing. Rehabilitation following bilateral tibial intramedullary. Eventually the nonunion healed seven months after the revision surgery fig. Ap f and lateral g views of medullary reamers over the guide pin. Trigen haste semirrigida com bloqueio transverso por. Nota bene the technique description herein is made available to the healthcare professional to illustrate the authors suggested treatment for the uncomplicated procedure. Russelltaylor delta tibial interlocking nail technique 598 kb recon interlocking nail technique 551 kb im. Management of infection after intramedullary nailing of. Titanium cannulated tibial nail surgical technique depuy synthes 5 indications the tibial nailex is intended to stabilize fractures of the proximal and distal tibia and the tibial shaft, open and closed tibial shaft fractures, certain pre and postisthmic fractures, and tibial malunions and nonunions. The 8mm t2 tibial nail can only be locked distally with 4mm fully threaded screws. For solid tibial nails utn, select the connecting screw for utn 356.
However, pain in the knee joint is the most common. Extending the indications of intramedullary nailing with. The trigen metanail tibial nail is indicated for fractures of the proximal and distal third of the tibia, including the shaft, stable and unstable metaphyseal fractures, nonunions, malunions, and for the prophylactic nailing of impending pathological fractures. Utilizing the same trigen instruments, the tan was developed to simplify the surgical approach by allowing placement of the nail through the greater trochanter instead of the piriformis fossa. Efficacy study of surgical technique in intramedullary tibia nailing, using trigen meta tibia nails trigenmeta the safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Verify and confirm location under biplanar fluoroscopic guidance. Indications include, but are not limited to, open and closed tibial shaft fractures. Internal splintage of open tibial fractures had gained acceptance as a preferred method of early stabilization of such injuries. The choice of treatment in each case was either plaster cast or intramedullary nail and was determined by the preference of the admitting consultant.
There is room for development of the method and improvement of instruments, thus increasing safety and indications. Fatigue strength of common tibial intramedullary nail distal locking screws article pdf available in journal of orthopaedic surgery and research 41. We conducted a multicenter, blinded randomized trial of 19 adults in whom a tibial shaft fracture was treated with either reamed or unreamed intramedullary nailing. The t2 femoral nailing system is one of the first femoral nailing systems to offer an option for either an antegrade or a retrograde approach to repair fractures of the femur. A more distal entry point may result in damage to the posterior cortex during nail insertion. The first and only virtual realtime imaging system for distal locking, new technology that offers full surgeon control, a reduction in radiation exposure, and shorter procedures from im nailing. Tibial intramedullary nail 3d cad model library grabcad. Suprapatellar nailing of tibial fractures is a simple method with many advantages over traditional tibial nailing.
Randomized trial of reamed and unreamed intramedullary. For distal tibia fractures, it is recommended that the surgeon use the largest nail diameter that will fit in the medullary canal, without excessive thinning of the cortex. In order to determine the risk factors associated with difficulties in nail removal, these five patients were compared in the parameters of age, gender, duration of nail in situ, nail diameter, nail length, and level of fracture with 30. Pdf fatigue strength of common tibial intramedullary nail. Trigen humeral nail features include trapezoidal nail profile, four multiplanar proximal screws and multiple lengths bent and straight. Reduced flexion leads to less pull from the quadriceps muscle, helping. Even more interesting was the absence of anterior tibial pain typically found in up to 25%60% of cases where a tibial nail is inserted in a standard fashion. In the international markets, the distal tibial nail is sold in select countries. Direct url citations appear in the printed text and are provided in the html and pdf versions of this article on the journals web site. May 23, 2011 efficacy study of surgical technique in intramedullary tibia nailing, using trigen meta tibia nails trigenmeta the safety and scientific validity of this study is the responsibility of the study sponsor and investigators. You may shower the day of surgery and the following 5 days with your bandage on as long as the bandage and knee stay dry.
The center point of the portal is located slightly medial to the lateral tibial spine as visualized on the ap radiograph and immediately adjacent and anterior. Open fracture tibia treated by unreamed interlocking nail. For cannulated tibial nails ctn, select the connecting screw for ctn 356. Difficulties in removing ace tibial intramedullary nail. Expert nailing system titanium cannulated tibial nail. The t2 tibial nailing system represents strykers latest and most comprehensive development of the original intramedullary principles presented by prof. Intramedullary nailing of proximal third tibial fractures. The top countries of suppliers are india, china, and india, from which the percentage of tibial nail supply is 17%, 72%, and 17% respectively.
Stryker has created a next generation locking nail system, bringing together all the capabilities and benefits of separate nailing systems to create a. A comparison of the relative costs of cast treatment and. Surgical technique for nail removal article pdf available in acta orthopaedica belgica 752. Tibial shaft fracture is considered the most common long bone in orthopaedic practice. The trigen metanail tibial nail is indicated for fractures of the proximal and distal third of the tibia, including the shaft, stable and unstable fractures, nonunions, malunions, and for the prophylactic nailing of impending pathological fractures. The final results had been evaluated through a scheme including 7 parameters. Fixation with intramedullary nail has frequently been used and proven to be efficient in displaced tibial shaft fractures 18.
Depending on the anatomical situation, nail lengths between 255 mm and 465 mm are available in 15 mm steps. Mar 01, 2010 tibial nail with locking screws in place, making the entry portal ce. Trigen meta nail tibial nail system surgical technique. Intramedullary nailing with expandable nails is one of the techniques available for the treatment of fractures of long bones. All described components are manufactured from titanium material. Trigen intertan intramedullary nail versus sliding hip screw a prospective, randomized multicenter study on pain, function, and complications in 684 patients with an intertrochanteric or subtrochanteric fracture and one year of followup kjell matre, md, tarjei vinje, md, leif ivar havelin, md, phd, janerik gjertsen, md, phd, ove furnes, md, phd. The compliance of the nail construct was adjusted by overdrilling the near cortex reliable fracture union since the surgeon can. The titanium tibial nail system royal childrens hospital.
Complications associated with the metanail tibial nail. Each patients case notes were analysed to identify the costs that were incurred in the first 18 months after the tibial fracture. Featured products within the trigen family include. A wide variety of tibial nail options are available to you, there are 370 suppliers who sells tibial nail on, mainly located in asia. Aug 28, 2003 we experienced three cases of refracture and two cases of failure to remove the nail while trying to take out ace tibial nails from healed tibial fractures. The objective of this study is to analyze the proximal tibiofibular joint in patients with knee pain after treatment of tibial shaft fractures with locked intramedullary nail. Efficacy study of surgical technique in intramedullary tibia. Trigen intertan intramedullary nail versus sliding hip screw. Length alignment rotation mobile joint mobile joint wb extremity when to nail gold standard for tibial shaft fractures possible in proximal and distal tibial fractures with appropriate technique. Efficacy study of surgical technique in intramedullary. Omar al bardan only the paranoid survive 9,674 views. As with all diameters of t2 tibial nails, the proximal screws are 5mm. Treatment of aseptic diaphyseal nonunion of the lower. All pdf files and may take some time to load be patient.
It is composed of a titanium alloy and is available in 4 diameters 8. The titanium cannulated tibial nail tg limelight networks. Complications associated with the metanail tibial nail end. The nails may be either solid or cannulated hollow. Discussion with development of the interlocking technique, the indications for intramedullary nailing have been expanded from merely isthmic tibial and femoral frac. One common compression screw to close the fracture site, and end caps in eight sizes are available to provide an improved fit for every indication. The distal nail tip should lie just above the tibial plafond figure 14. It is a computerassisted orthopaedic surgery tool to aid the surgeon with drill positioning for screws during intramedullary nail implantation. Semiextended intramedullary nailing of the tibia using a. In 1958, the ao formulated four basic principles, which have become the guidelines for. The device is indicated for degeneration, deformity, or trauma of both the tibiotalar and talocalcaneal articulations in the hindfoot.168 646 570 1382 901 1277 1479 1421 258 178 51 1558 491 413 796 363 842 847 1480 104 1084 912 105 339 552 559 1439 559 1208 351 1118