Surgical technique for nail removal article pdf available in acta orthopaedica belgica 752. As with all diameters of t2 tibial nails, the proximal screws are 5mm. Pdf fatigue strength of common tibial intramedullary. 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. 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. It is composed of a titanium alloy and is available in 4 diameters 8. A wide variety of tibial nail options are available to you, there are 370 suppliers who sells tibial nail on, mainly located in asia.
Complications associated with the metanail tibial nail end. Semiextended intramedullary nailing of the tibia using a. Hold a sterile expert tibial nail on the lateral side of the lower leg with its distal end parallel to the tibia shaft. Management of infection after intramedullary nailing of. Trigen meta nail tibial nail system surgical technique. Rehabilitation following bilateral tibial intramedullary. Intramedullary nailing with expandable nails is one of the techniques available for the treatment of fractures of long bones. In 1958, the ao formulated four basic principles, which have become the guidelines for. 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. Suprapatellar nailing of tibial fractures is a simple method with many advantages over traditional tibial nailing. In 1958, the ao formulated four basic principles, which have become the guidelines for internal fixation in general,1. In conclusion, we agree that intramedullary nailing is a very satisfactory treatment for unstable tibial diaphyseal fractures with a low rate of serious complications. Nota bene the technique description herein is made available to the healthcare professional to illustrate the authors suggested treatment for the uncomplicated procedure. Depending on the anatomical situation, nail lengths between 255 mm and 465 mm are available in 15 mm steps.
Omar al bardan only the paranoid survive 9,674 views. 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. The trigen tan is used for the same indications as the standard trigen fan. Rehabilitation following bilateral tibial intramedullary nail placement in an elite athlete sharon young abney, spt. The 8mm t2 tibial nail can only be locked distally with 4mm fully threaded screws. Trigen meta nail tibial nail is the latest addition to the trigen family of intramedullary nails 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. Please keep in mind that variations in magnification do occur. Efficacy study of surgical technique in intramedullary. In the international markets, the distal tibial nail is sold in select countries. Trigen intertan intramedullary nail versus sliding hip screw. If the offset driver handle should loosen slightly during insertion, tighten it down before continuing. Download download trigen humeral nail surgical technique pdf writer read online read online trigen humeral nail surgical technique pdf writer official fulltext paper pdf. 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.
The device is indicated for degeneration, deformity, or trauma of both the tibiotalar and talocalcaneal articulations in the hindfoot. The nails may be either solid or cannulated hollow. Russelltaylor delta tibial interlocking nail technique 598 kb recon interlocking nail technique 551 kb im. Randomized trial of reamed and unreamed intramedullary. 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. 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. For solid tibial nails utn, select the connecting screw for utn 356. 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. The top countries of suppliers are india, china, and india, from which the percentage of tibial nail supply is 17%, 72%, and 17% respectively. Solid nails may protect somewhat against infection because they have no internal dead space. 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. Verify and confirm location under biplanar fluoroscopic guidance. Indications include, but are not limited to, open and closed tibial shaft fractures.
The compliance of the nail construct was adjusted by overdrilling the near cortex reliable fracture union since the surgeon can. Tibial shaft fracture is considered the most common long bone in orthopaedic practice. Internal splintage of open tibial fractures had gained acceptance as a preferred method of early stabilization of such injuries. Trigen metanail instrumentation bmt medical devices.
Intramedullary nailing of proximal third tibial fractures. Complications associated with the metanail tibial nail. All described components are manufactured from titanium material. Tibial nailing is related with relatively low incidence of nonunion, malunion, infection and compartmental syndrome 911. Management of infection after intramedullary nailing. Featured products within the trigen family include. 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.
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. Difficulties in removing ace tibial intramedullary nail. Discussion with development of the interlocking technique, the indications for intramedullary nailing have been expanded from merely isthmic tibial and femoral frac. Freedman and johnson 2 reported malalignment defined as a. Fixation with intramedullary nail has frequently been used and proven to be efficient in displaced tibial shaft fractures 18. The t2 tibial nailing system is the realization of superior biomechanical intramedullary stabilization using small caliber, strong cannulated. Stryker has created a next generation locking nail system, bringing together all the capabilities and benefits of separate nailing systems to create a. Trigen humeral nail surgical technique pdf writer telegraph. 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. Each patients case notes were analysed to identify the costs that were incurred in the first 18 months after the tibial fracture. Knee nail for tibial fractures trigen im nail system surgical technique described by thomas a. Phoenix tibial nail system featuring corelocktm technology.
Nailing in extension for trigen meta nail tibial nails. Pdf fatigue strength of common tibial intramedullary nail. It is a computerassisted orthopaedic surgery tool to aid the surgeon with drill positioning for screws during intramedullary nail implantation. Russell, md, mba university of mississippi medical center treatment goals shaft fracture. Tibial intramedullary nail 3d cad model library grabcad. Efficacy study of surgical technique in intramedullary tibia. The choice of treatment in each case was either plaster cast or intramedullary nail and was determined by the preference of the admitting consultant.
Trigen humeral nail features include trapezoidal nail profile, four multiplanar proximal screws and multiple lengths bent and straight. 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. The titanium cannulated tibial nail tg limelight networks. However, pain in the knee joint is the most common. All pdf files and may take some time to load be patient. One implant, two approaches stryker has created a next generation locking nail system, bringing together all the capabilities and benefits of. 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 metaphyseal fractures, nonunions, malunions, and for the prophylactic nailing of impending pathological fractures. 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. 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. 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.
When selecting the appropriate nail size take all aspects of the fracture into consideration. Eventually the nonunion healed seven months after the revision surgery fig. Mar 01, 2010 tibial nail with locking screws in place, making the entry portal ce. 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. The cannulated tibial nail ctn is intended to stabilize fractures of the tibia. Trigen meta nail retrograde femoral nail is indicated for fractures of the femur including stable and unstable distal metaphyseal fractures.
Drive the nail until the proximal end is even with the tip of the greater trochanter. Treatment of aseptic diaphyseal nonunion of the lower. A more distal entry point may result in damage to the posterior cortex during nail insertion. 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. There is room for development of the method and improvement of instruments, thus increasing safety and indications. Mar 02, 2017 ao percutaneous iliosacral screw insertion, supine upper sacral segment duration. The final results had been evaluated through a scheme including 7 parameters. The t2 tibial nailing system represents strykers latest and most comprehensive development of the original intramedullary principles presented by prof. Fatigue strength of common tibial intramedullary nail distal locking screws article pdf available in journal of orthopaedic surgery and research 41. When treating distal tibia fractures with a tibial nail, stresses are increased on the nails distal portion. 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. Ap f and lateral g views of medullary reamers over the guide pin. Tibia intramedullary nail postop instructions wound care bathing. These line additions are comprised of retrograde femoral, supracondylar, and tibial intramedullary nails and a nail cap.
All intertan nail templates are available with 117% magnification to compensate for radiographic magnification. For cannulated tibial nails ctn, select the connecting screw for ctn 356. 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. Ao percutaneous iliosacral screw insertion, supine upper sacral segment duration. 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. 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. Reduced flexion leads to less pull from the quadriceps muscle, helping. Trigen haste semirrigida com bloqueio transverso por.
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. 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. Expert nailing system titanium cannulated tibial nail. Tibial nails have locking screw holes close to both ends, in multiple orientations, for better fixation of proximal and distal fractures. You may remove your bandage 5 days after surgery except the steristrips on the skin, if you have them. 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. 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. Extending the indications of intramedullary nailing with the. Open fracture tibia treated by unreamed interlocking nail. Deborah michael wendland, pt, dpt, phd, cped mercer university atlanta, ga abstract background. 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. They were followed from july 2008 to march 20 56 months with an average time of 39 months. The titanium tibial nail system royal childrens hospital.
Recommendations for avoiding knee pain after intramedullary. Rehabilitation following bilateral tibial intramedullary nail. The distal nail tip should lie just above the tibial plafond figure 14. Intramedullary im nailing is the preferred method of treatment for tibial stress fractures because of. Scribd is the worlds largest social reading and publishing site. Intramedullary im nailing is the preferred method of treatment for tibial. Utilizing the same trigen instruments, the tan was developed to simplify the surgical approach by. In the final analysis, the preferred treatment is that. Extending the indications of intramedullary nailing with.
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. Reduced flexion leads to less pull from the quadriceps muscle, helping to avoid fracture malreductions and malalignment. Both antegrade femoral nails are designed to accommodate a standard femoral locking mode or the recon locking mode in the same leg. Enhanced fixation dedicated instruments for blocking screws and extension nailing. There are a full range of sizes for a comprehensive approach to the treatment of femoral fractures. 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.
Trigen humeral nail proximal and long trigen hindfoot nail. Trigen knee nail and distal tibial nail specifications driving end of nail all knee nails and distal tibia nondriving end of nail ml view the distal tibial nail is on limited release, in the us market. A comparison of the relative costs of cast treatment and. In fractures within 30 mm of the plafond robinson shortened the nail to enable the placement of two inter.
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