How is the trigen intertan intertrochanteric antegrade nail different. Push down on the top of ruler until contact is made with the 3. Place a sterile bolster leg roll or use a leg positioner under the thigh and. An infrapatellar and patellar tendon splitting entry to the tibia with the knee joint flexed 90 degrees seems to be the preferred entry for tibial nailing. The course will explore tibial nailing, retrograde femoral nailing and antegrade femoral nailing diaphyseal and cephalomedullary, examining each of the following.
Zelle1 and guilherme boni2 abstract statically locked, reamed intramedullary nailing remains the standard treatment for displaced tibial shaft fractures. Biomet, as the manufacturer of this device, does not practice medicine and does not recommend this or any other surgical technique for use on a specific patient. Place an intramedullary reamer over the guide wire and ream the tibial. It is composed of a titanium alloy and is available in 4 diameters 8. Removal of a broken intramedullary nail may be a real challenge. May 14, 20 the standard approach to lateral tibial plateau fractures involves elevation of the iliotibial band it and anterior tibialis origin in continuity from gerdys tubercle and metaphyseal flare. Download the trigen meta nail tibial surgical technique the evidence is in wound. Blind nailing technique for insertion of the triflange medullar nail. Trigen meta nail tibial nail system surgical technique.
Pdf complications associated with the metanail tibial nail end. The compliance of the nail construct was adjusted by overdrilling the near cortex reliable fracture union since the surgeon can tailor the nail compliance to the in the current study, an anglestable im nail implantation technique was trigen meta nail system, tibial and retrograde femoral nail. Intertan nails designed for stability the trigen intertan nail was designed as a trochanteric portal intramedullary nail especially shaped for fractures of the proximal femur. Please keep in mind that variations in magnification do occur. Enhanced fixation via threaded screw holes and polyethylene bushings offer excellent solutions for the fixation of complex fractures. Distal tibial intramedullary nailing utilizing an extraarticular, lateral parapatellar approach courtesy. This arthrodesis nail brochure is presented to demonstrate the surgical technique utilized by michael o. Complications associated with the metanail tibial nail end cap.
Trigen meta nail retrograde femoral nail is indicated for fractures of the femur including stable and unstable distal metaphyseal fractures this website uses cookies to help you get the most out of your experience during your visit, and we can improve the content served to. The intertan system offers anatomically shaped trapezoidal implants as opposed to conventional circular shaped intramedullary nails. As with all diameters of t2 tibial nails, the proximal screws are 5mm. The proximal section of the implant is mm and is angled at 5 to accommodate the more lateral entry site. Surgical technique femur interlocking nail matrix meditec. Recently, suprapatellar nailing in the semiextended position has been suggested as a safe and effective surgical technique. This illustration from the surgical technique manual demonstrates. Gamma3 long nail is intended for fixation of stable and unstable femoral fractures occurring from the base of the femoral neck extending distally to a point approximately 10cm proximal to the intracondylar notch including fractures of the basilar neck, intertrochanteric fractures, peritrochanteric fractures, subtrochanteric fractures and femoral shaft fractures. Trigen fan femoral antegrade nail and tan indications. Nonunion of long bones fixed with nails may result in implant failure. If the length indicated is between two available nail sizes, it is recommended that the shorter nail be chosen. 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. Dec 12, 2015 statically locked, reamed intramedullary nailing remains the standard treatment for displaced tibial shaft fractures.
Tibial bone transport over an intramedullary nail using cable and pulleys duration. Trigen meta nail retrograde femoral nail is indicated for fractures of the femur including stable and unstable distal metaphyseal fractures this website uses cookies to help you get the most out of your experience during your visit, and we can improve the content served to you by collecting statistical information. For information on the use of blocking screws, refer to the trigen meta nail tibial nail surgical technique 71181610. Intramedullary tibial nail insertion was performed following reaming for all patients. Mdn tibial intramedullary nail utilizing the mis tibial. Generally, a nail diameter 1 mm less than the final reamer diameter is chosen. Trigen humeral nail features include trapezoidal nail profile, four multiplanar proximal screws and multiple lengths bent and straight. These views are not to scale and should be used as a pictorial representation only. Expert tibial nail surgical technique depuy synthes 11 3 confirm nail length and diameter instrument 03. Trigen humeral nail surgical technique pdf writer telegraph. 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 titanium tibial nail system surgical technique 9 measuring device for utnctn 356. Not limiting the approach to a certain nailing technique accommodating reamed or unreamed procedures providing locking options for. The trigen meta nail tibial nail is the latest addition to the trigen family of intramedullary nails.
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. Efficacy study of surgical technique in intramedullary tibia. The use of the three locking screws in the proximal oblique locking options ensures optimal stabilization of the expert tibial tail in the proximal fragment. The purpose of this article is to present a simple technique for suprapatellar nailing spn of tibial fractures providing stepbystep instruction supplemented with relevant illustrations. This surgical technique offers guidance but, as with any such technique guide each surgeon must consider the particular needs of each patient and make. The trigen hindfoot fusion nail hfn brings the simplified instrumentation of the trigen nail system to the hindfoot. Surgical approaches and guide wire entry points fracture reduction techniques reaming techniques surgical techniques for each system. Suprapatellar nailing of tibial fractures is a simple method with many advantages over traditional tibial nailing. Universal tibial nail ii surgical technique youtube. When treating distal tibia fractures with a tibial nail, stresses are increased on the nails distal portion. Expert nailing system titanium cannulated tibial nail. Trigen intertan surgical technique surgical tech classes. There is room for development of the method and improvement of instruments, thus increasing safety and indications.
To estimate nail diameter, place the template on the ap or lateral xray of the uninjured tibia and measure the diameter of the medullary canal at the narrowest part that will contain the nail. The modern technique of intramedullary nailing was largely developed and perfected by the dedicated work of the german surgeons gerhard kuntscher and his student, richard maatz. The 8mm t2 tibial nail can only be locked distally with 4mm fully threaded screws. The patient was supine and fitted with an inflated tourniquet.
Semiextended intramedullary nailing of the tibia using. One implant, two approaches stryker osteosynthesis has created a locking nail system, bringing together all the capabilities and benefits of separate antegrade and retrograde nailing. Efficacy study of surgical technique in intramedullary. Chirstopher mcandrew, william ricci and the orthopaedic trauma association. The trigen metanail tibial nail system is designed specifically to repair fractures of the proximal and distal thirds of the tibia, including the shaft, stable and unstable fractures, nonunions, malunions, and for the prophylactic nailing of impending pathological fractures. The effectiveness of the external distal aiming device in intramedullary fixation of tibial shaft fractures article in archives of orthopaedic and trauma surgery 12710. The t2 humeral nailing system is systems to offer an option for either an antegrade or a retrograde approach to repair fractures of the humerus.
Statically locked, reamed intramedullary nailing remains the standard treatment for displaced tibial shaft fractures. Intramedullary nailing system has become increasingly popular as a treatment option for long bone fractures, it is suitable for all fractures extending from 78 cm distal to the tibial plateau, to within 5. Intramedullary nailing of the tibia orange county surgeons. Tibial intramedullary nails are still largely inserted through a.
For implantation using the suprapatellar approach, instrumentation systems trigen meta tibia nail. Place the patient supine on a radiolucent table and position the knee for a tibial nailing procedure. This educational video presents a surgical technique for placement of an intramedullary tibial nail for a tibia shaft fracture through a stepbystep approach. Adapted from trigen metanail tibial nail system surgical technique, p. A more distal entry point may result in damage to the posterior cortex during nail insertion. The trigen meta nail tibial nail system is designed specifically to repair fractures of the proximal and distal thirds of the tibia, including the shaft, stable and unstable fractures, nonunions, malunions, and for the prophylactic nailing of impending pathological fractures. All intertan nail templates are available with 117% magnification to compensate for radiographic magnification. This freehand technique is timeconsuming and exposes the patient, surgeon and. Complications associated with the metanail tibial nail end.
Nailing in extension for trigen meta nail tibial nails. Trigen tan and fan intramedullary nails surgical technique. Intramedullary nailing of the tibia may be utilized in cases of tibial fracture or tibial fracture malunion or nonunion. We describe an alternative approach to increase lateral plateau joint exposure and maintain iliotibial band insertion to gerdys tubercle. Surgical procedures of intramedullary nailing of the tibia on intramedullary nailing of the tibia involves the insertion of a nail into the tibia in order to prevent or correct a fracture.
Verify and confirm location under biplanar fluoroscopic guidance. When treating distal tibia fractures with a tibial nail, stresses are increased on the nail. Trigen metanail tibial nail specifications driving end of nail all knee and distal tibial top view of nail nondriving end of nail ml view ap view set does not include all sizes. An example of a surgical procedure includes but is not limited to locating and drilling the distal holes in an intramedullary nail. Russelltaylor delta tibial interlocking nail technique. Complications associated with the metanail tibial nail. Providing locking options for all types of fractures, plus the advanced locking mode for increased rotational stability. Introduction surgical technique product information table of contents titanium cannulated tibial nail expert system 2 ao principles 4 indications 5 clinical cases 6 preoperative planning 8. New surgical technique and presentation of first 30 cases article pdf available in injury november 2018 with 104 reads how we measure reads. The phoenix tibial nail system is composed of titanium alloy and features corelock technology that offers a preassembled, embedded locking mechanism for locking all proximal oblique screws, which can also be used to internally mechanically compress up to 5mm for a variety of tibial. Mar 01, 2010 nail design and instrumentation have advanced greatly since kuntschers nail, yet the surgical technique has changed little. Electromagnetic device enables accurate placement of im nail.
The treating surgeon is responsible for determining the appropriate treatment, technique s, and products for each individual patient. Implant length is read from the exposed calibrations at the end of the ruler. For nail sizes 811 mm, the proximal diameter is 11. This website uses cookies to help you get the most out of your experience during your visit, and we can improve the content served to you by collecting statistical information. When selecting the appropriate nail size take all aspects of the fracture into consideration. The trigen intertan nail at healing effective in reducing the potential role of the tip of the short nail as a stress riser26 quote taken from a single prospective comparative study challenge. If the indications for nailing of proximal and distal tibial fractures are extended, this is a challenge for surgical techniques.
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 tibial bone transport over an intramedullary nail using cable and pulleys duration. Furthermore, the development of the t2 femoral nailing system offers the competitive advantages of. With a full range of sizes, the tibial nail is a comprehensive approach to the treatment of tibial fractures. Semiextended approach for intramedullary nailing via a. Distal end of nail all knee and distal tibial top view of nail nondriving end of nail ap view ml view set does not include all sizes. Specifications trigen tan nail material ti6al4v diameter 10, 11. The t2 tibial nailing system is the realization of superior biomechanical intramedullary stabilization using small caliber, strong cannulated. The trigen hfn features an oblique locking configuration that allows surgeons to maximize thread purchase by locking into better bone. The approach entails a partial tenotomy of the anterior half. Intramedullary nailing of the tibia may be utilized in cases of tibial fracture or tibial.
Through the development of a common, streamlined and intuitive surgical approach, both in principle and in detail, the t2 tibial nailing. The trigen tan and fan intramedullary nails are indicated for fractures of the femur, including intertrochanteric, basitranscervical femoral neck fractures and subtrochanteric fractures, ipsilateral femoral neckshaft fractures, stable and unstable shaft fractures, segmental fractures, nonunions and malunions, polytrauma. Both antegrade femoral nails are designed to accommodate a standard femoral locking mode or the recon locking mode in the same leg. Many methods have been described to allow for removal of the broken piece of the nail.
Avoid overinsertion of the guide wire as this can establish a false trajectory and lead to fracture malalignment. Confirm guide rod position in the window at the opposite end of the ruler as shown in order to ensure accurate implant measurement. Trigen im nail system surgical technique norsk trigen im nail system surgical technique knee nail for tibial fractures as described by thomas a. The use of a sp portal adds a novel percutaneous component to. Removal of a broken cannulated intramedullary nail.
If implanted, remove the nail cap or nail cap set screw by using the medium hexdriverthandle assembly. The im nail length gauge can only be used with 100cm guide wire. Phoenix tibial nail system featuring corelocktm technology. Enhanced fixation via threaded screw holes and polyethylene bushings offer better solutions for the fixation of complex fractures. Trigen intertan hip fracture intramedullary nail bmt. For nail sizes 12 and mm, the proximal nail diameter matches the shaft diameter. Position the carm for an ap view of the distal tibia. Sep 14, 2017 universal tibial nail ii surgical technique implantes 3d.
Surgical technique 3 preoperative planning 3 patient positioning 3 reduction 3 starting point location 3 reaming 4 nail assembly and insertion 5 proximal screw placement 8 distal targeting freehand technique 10 axial compression 11 finalize implant placement 12 postoperative care 12 nail extraction 12 tibial nail details. The subpatellar approach was preferred, and the tibial canal. M dn tibial intramedullary nail utilizing the s tibial guide surgical technique 7 location. The phoenix tibial nail system is composed of titanium alloy and features corelock technology that offers a preassembled, embedded locking mechanism for locking all proximal oblique screws, which can also be used to internally mechanically compress up to 5mm for a variety of tibial fractures. Numerous reduction techiques are available to achieve an anatomic. Tibial nail surgical technique advanced orthopaedic solutions. Intertan nail surgical technique surgical tech classes. Before the operation, it is recommended to examine patellar laxity on the injured leg, or as an alternative the healthy leg. Establishing an appropriate starting point is a crucial part of the surgical procedure. Trigen humeral nail proximal and long trigen hindfoot nail. The titanium tibial nail system royal childrens hospital.
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