Expert tibial nail surgical technique depuy synthes 1. Between january 1, 2006, and december 31, 2009, a total of 158 consecutive adult patients sustaining tibial shaft fractures underwent reamed im nailing at the authors. Elastic nail insertion sleeves designed to serve as working channel to protect joint space. Mar 31, 2016 the first group was treated with an expert tibia nail and 4 distal screws, and the second group with a solid conventional distal locking nail unreamed tibial nail. In 1958, the ao formulated four basic principles, which have become the guidelines for internal fixation in general,1. May 10, 2017 stryker continues to build on its history of innovation with the introduction of the t2 tibia suprapatellar instrument spi system. Numerous reduction techiques are available to achieve an anatomic. Suprapatellar instrumentation for expert tibial nail. The tibial nail is designed to help treat various fractures of the tibia. The titanium tibial nail system royal childrens hospital. Pdf the retrograde tibial nail a new implant concept for.
Depuy synthes suprapatellar instrumentation for titanium cannulated tibial nails surgical technique. Distally, the expert tibial nail can be locked with two ml locking screws see. Calcaneal fracture orif with lateral approach, plate fixation, and locking screws. Extending the indications of intramedullary nailing with the. Attach the anterior drop 71654501 to the drill guide and verify targeting accuracy by inserting a gold 9. This site is for visitors from europe, middle east and africa. Biomedical science and engineering, 201 1, 4, 235241 jbise. Intramedullary nail for treating proximal, distal, as well as midshaft tibial fractures.
Patients underwent followup 6 weeks, 3, 6, and 12 months with standard radiographs, as well as visual analog. The expert tibial nail with protect coating releases high concentrations of antibiotics into the implants surroundings to protect your patients from bacterial colonization of the implant. When treating distal tibia fractures with a tibial nail, stresses are increased on the nails distal portion. Reference chart synthes usa 2 wrights lane east west chester, pa 19380. Moreover an unreamed intramedullary nail expert tibial nail depuy synthes stabilized the fractured tibia. 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 expert tibial nail synthes was equipped with either three conventional locking screws cl or the anglestable locking system as, consisting of a special asls screw and a biodegradable sleeve. A 9mm cannulated expert tibial nail was advanced over the guidewire using the inser tion handle. Ankle simple bimalleolar fracture orif with tubular plate and cannulated screw of medial malleol. Techniquenail insertion for pediatric femur opening the femur creating the nail entry point make an incision on the lateral or medial aspect of the distal femur, starting 3 cm above the physis and extending distally for 2.
Tibial plafond fracture orif with anterolateral approach and plate fixation. The healing stages of an intramedullary implanted tibia. Pdf intramedullary nailing of humeral shaft fractures. Ao principles 4 synthes titanium cannulated tibial nail expert system technique guide 1. Position the carm for an ap view of the distal tibia. Expert tibia nail depuy synthes pdf catalogs technical. Furthermore, the development of the t2 femoral nailing system offers the competitive advantages of. Instructions for use intramedullary nailing implants. Influence of nail prominence and insertion point on anterior. The t2 alpha tibia nailing system offers a combination of innovation, simplicity, and efficiency that is designed to suit your various needs. It offers double proximal and triple distal interlocking with an end cap leading to an anglestable. For nail sizes 12 and mm, the proximal nail diameter matches the shaft diameter. Both implants were fixed with double proximal and triple distal interlocking. Expert tibial nail surgical technique depuy synthes 11 3 confirm nail length and diameter instrument 03.
Distal locking of tibial nails article pdf available in clinical orthopaedics and related research 4661. The titanium cannulated tibial nail ex offers a variety of proximal and distal locking options, giving the surgeon the ability to tailor fixation to the fracture pattern. The titanium tibial nail system surgical technique 16 inserting the nail for the solid utn, place the nail into the tibial opening with the insertion handle oriented anteriorly. Nailing in the semiextended position has recently gained increased attention in the orthopedic literature. The expert tn protect is indicated for fractures in the tibial shaft as well as for metaphyseal and certain intraarticular fractures of the tibial head and the pilon tibiale. Depuy synthes ti6al7nb unreamed femoral nail mr conditional 20. The tibial nail ex with proximal bend 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 t2 tibial nailing system is the realization of superior biomechanical intramedullary stabilization using small caliber, strong cannulated.
Securely lock the most proximal oblique locking screw to. Titanium cannulated tibial nail expert nailing system surgical technique depuy synthes trauma 5 indications the tibial nail ex 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. Expert nailing system titanium cannulated tibial nail. Screws are placed through the nail to secure the implant in place and maintain length and alignment while healing occurs. Distal locking screws for intramedullary nailing of tibial. A load of 700 n has been applied at the top of pelvis and a part the feet, at the tip, was rigidly fixed. Titanium cannulated tibial nailex with proximal bend j. Depending on the anatomy of the patient, this incision can be transpatellar, medial or even lateral parapatellar. December 26, 2018 elizabeth jacobs regulatory affairs project. Jan 31, 2015 their articular cartilage layers, were simulated by 3d membranes of opportune stiffness connecting the different segments. Suprapatellar versus infrapatellar tibial nail insertion. With the help of the aiming device, 2 mediolateral static screws were used for locking the proximal part of the nail.
The titanium cannulated tibial nail ex is available in a universal design for the left or right tibia, with a 10. Used with the t2 tibial nailing system, the spi instruments. The nails have been designed for specific applications to help restore the shape of the fractured bone to its natural, preinjured state. The universal nail system titaniumstainless steel elastic nail system ufn unreamed femoral nail cfn cannulated femoral nail uhnphn humeral nailing system utnctn solidcannulated tibial nail please read these instructions for use, the synthes important information and the corresponding surgical technique carefully before use. Pdf biomechanical comparison of distal locking screws for. As with all diameters of t2 tibial nails, the proximal screws are 5mm.
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. Seven biomechanical composite tibiae were treated with either osteosynthesis techniques. All technique guides are available as pdf files at. Depuy synthes universal tibial nail and the depuy synthes unreamed tibial nail mr conditional 19. Titanium alloy tan for improved mechanical and fatigue.
If the reamer is not advancing, remove it and clear away the bone debris. The sp also underwent prenail and postnail insertion patellafemoral pf joint arthroscopy. Tibial nail data indicates that the tibia is the most commonly fractured long bone in the body. Establishing an appropriate starting point is a crucial part of the surgical procedure. The 8mm t2 tibial nail can only be locked distally with 4mm fully threaded screws. Wchcoated fixation kwires designed for secure fixation in tibial plateau to prevent anteriorization and back out of sleeves during reaming. As a first result the proximal tibial nail ptn, synthes was designed and clinical investigation was started in 1999. 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. Apr 20, 2017 dental assisting training video for dental office staff. The zimmer natural nail system is a system of intramedullary nails, screws, instruments and other associated implants that are designed to provide stable internal fixation for fractured long bones.
For the cannulated ctn, place the nail over the guide rod and into the tibial opening with the insertion handle oriented anteriorly. Dec 12, 2015 statically locked, reamed intramedullary nailing remains the standard treatment for displaced tibial shaft fractures. Recently, suprapatellar nailing in the semiextended position has been suggested as a safe and effective surgical technique. Ream to a width 12 mm greater than the proposed nail. The nail has multiple screw holes in the proximal body to allow surgeons to address different fracture types. The first group was treated with an expert tibia nail and 4 distal screws, and the second group with a solid conventional distal locking nail unreamed tibial nail.
Generally, a nail diameter 1 mm less than the final reamer diameter is chosen. The markings on the handle helped to insert the nail to the same depth in each model. 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. From lowenergy contact in sports to auto and factory accidents, its a fracture touching every demographic. Jul 28, 20 in a multicentre european study, attal et al. Remove the awl and insert the tibial reamer sleeve 174230. All surgical techniques are available as pdf files at ifu. For nail sizes 811 mm, the proximal diameter is 11. The retrograde tibial nail rtn is a prototype intramedullary implant developed by our group. More distal locking pattern with most distal hole remaining 5mm from tip. A tibial nail for insertion into the medullary canal of the tibia in a retrograde manner comprising.
This site is published by the depuy synthes companies, which are solely responsible for its content. Depuy synthes ti6al7nb unreamed tibial nail urtn mr conditional 21. The expert tibial nail etn is standard in treating tibial fractures with a wide range of indications. The expert tibial nail is indicated for fractures in the tibial shaft as well as for metaphyseal. Suprapatellar instrumentation for expert tibial nail technique guide. Trigen meta nail 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. A biomechanical comparison of the current rtn prototype against antegrade nailing expert tibial nail, synthes, etn was performed. In 1958, the ao formulated four basic principles, which. Biomechanical comparison of distal locking screws for distal tibia fracture intramedullary nailing.
Introduction expert tibial nail 2 ao principles of internal fixation 4 surgical technique preoperative planning 8 product information implant specifications 60 c. Phoenix tibial nail system featuring corelocktm technology. Ankle isolated lateral malleolus fracture orif with lag screw. The t2 tibial nailing system is intended to provide temporary stabilization of various types of fractures, malunion and nonunion of the tibia. Instructions for use synthes expert tn protect with. T2 tibia spi offers two size options of drill sleeve available to accommodate nail diameters 8mm. Accessories to depuy synthes titanium alloy unreamed femoral nail urfn mr conditional 22. Pdf biomechanical comparison of distal locking screws.
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