Zimmer natural nail system tibial nail surgical technique. Intramedullary nailing is the standard procedure for surgical treatment of closed and gustiloanderson grade iii open fractures of the tibial shaft. With newer nail designs and attention to technique, nailing can be extended to both proximal and distal extraarticular fractures. Position the carm for an ap view of the distal tibia. The titanium cannulated tibial nail ex is available in a universal design for the left or right tibia, with a 10. Zimmer natural nail system tibial nail surgical technique suprapatella table of contents product overview 2 implant overview 2 indications 2 contraindications 2 surgical technique 3 preoperative planning 3 patient positioning 3 reduction 3 starting point location 3 reaming 6 nail assembly and insertion 6 proximal screw placement 9. Although limited clinical series exist and not every author has had equal success with this. T2 alpha tibia nailing system the t2 alpha tibia nailing system offers a combination of innovation, simplicity, and efficiency that is designed to suit your various needs. Intramedullary nail fixation of tibial shaft fractures.
This comprehensive textbook on fin is written by pierre lascombes and his colleagues from the university of nancy and covers all its potential applications. Albanian association of orthopaedic surgery and traumatology. The first part focuses on general considerations such as biomechanics, choice of implant, basic principles of surgical technique, and rehabilitation. This book includes detailed descriptions and photographs taken in actual clinical settings. Right here, we have countless books flexible intramedullary nailing in. Ream 1 mm over the planned tibial nail diameter, insert the im nail and lock the proximal end of the nail using 2 medialtolateral sign locking screws. Zimmer natural nail system tibial nail surgical technique table of contents product overview 2 implant overview 2 indications 2 contraindications 2 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. Not limiting the approach to a certain nailing technique.
Ender nailing for tibial shaft fractures can be classified into three methods a, b, and c, according to the insertion points of the nails. By using this manual as a foundation, the radiologic technologist will be able to master many of. Never insert a nail that has a larger diameter than the last reamer used. When treating distal tibia fractures with a tibial nail, stresses are increased on the nail s distal portion. Trabecular metal natural cup system acetabular reaming use progressively larger reamers to prepare the acetabulum. Kindle versus ipad for reading books znn tibial nail surgical technique book pdf. The surgical management of distal tibia diaphyseal fractures ota classification type 42a, 42b, and 42c and distal metaphyseal tibia fractures with or without intraarticular extension ota classification type 43a, 43b1 or 43b2, and 43c1 or 43c2 with an intramedullary implant can be successfully performed with the utilization of appropriate aids and proper techniques. Im nailing surgical procedure insert guide wire and progressively ream to get chatter select nail and attach insertion handle 5 depuysynthes trauma, synthes gmbh, expert tn. The location of the entry point in relation to the tibial tubercle varies with patient anatomy. The t2 tibial nailing system is indicated for long bone fracture fixation. This intramedullary nail system is available in a variety of diameters and lengths with varying anterior bows to accommodate varying patient anatomy for post osteotomy fixation. European society of sports traumatology knee surgery and. Zimmer natural nail system tibial suprapatella mrloanbook.
In 60% of whom, the pain was exacerbated by kneeling. When treating distal tibia fractures with a tibial nail, stresses are increased on the nail. Anhthu animalu anita anjali anjen ann ann1 anna anna1 annabel annabela. Tibial nail system offers the competitive advantages of. For nail sizes 12 and mm, the proximal nail diameter matches the shaft diameter. The nails are inserted using an opened or closed technique and can be statically, dynamically and compressed locked.
Secure the em tibial guide body to the tibia with one attach the tibial stylus to the universal tibial cutting pin headed threaded, placed in either the medial or block by placing the appropriate stylus tongue into the. Used with the t2 tibial nailing system, the t2 tibia suprapatellar instrument system offers an alternate method for the insertion of tibial spi nails in a suprapatellar approach with the patients in a semiextended position. T2 tibia spi offers two size options of drill sleeve available to accommodate nail diameters 8mm. For these indications the expert tibial nail should be used in combination with other implants not shown in the illustrations. The radiology technologists handbook to surgical procedures provides a quick reference for using fluoroscopic and xray equipment during surgical procedures. 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. Statically locked, reamed intramedullary nailing remains the standard treatment for displaced tibial shaft fractures. Techniques for intramedullary nailing of proximal tibia. Screws are placed through the nail to secure the implant in place and maintain length and. Numerous reduction techiques are available to achieve an anatomic. Alvira alvord amadeus amadeus1 amalia amanda amazon amber amberg. The purpose of our study was to investigate the safety and efficacy of elastic stable intramedullary nailing for unstable pediatric tibial shaft fractures using titanium elastic nails tens. The zimmer natural nail system is a next generation of intramedullary nails. Suprapatellar nailing of tibial fracturesindications and.
The titanium tibial nail system surgical technique identify nail entry point the entry point for the nail is in line with the medullary canal in the ap view, and is at the anterior edge of the tibial plateau. Nail length, locking screw length and nail cap size may be determined. Intramedullary fixation is valuable and appropriate for the majority of tibial fractures. Bedside ultrasonography for the detection of small. Intramedullary nail for treating proximal, distal, as well as midshaft tibial fractures. Clinical experience of 30 fractures of distal tibial shaft treated with the znn anatomic nail. 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. Significance of the position of the proximal tip of the. Biomechanical evaluation of extramedullary versus intramedullary. To our knowledge, this is the largest series reported in the literature of this specific fixation technique. 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. The titanium cannulated tibial nail ex is available in a universal design for the left or right tibia, with a.
They are characterized by their anatomic shape, which is intended to replicate the natural anatomic shape of the various long bones in the human skeleton. An intramedullary rod, also known as an intramedullary nail im nail or interlocking nail or kuntscher nail without proximal or distal fixation, is a metal rod forced into the medullary cavity of a bone. Cephalomedullary nails long nail versatile distal hole options with zimmer stabilize technology anatomic anterior bows varying with the nail length 3034 cm 1. 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. Intramedullary nail fixation is a safe and effective method for treating tibial shaft fractures, and with appropriate surgical technique good outcomes and reproducible results can be expected. 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. The technique is written to explain use of the suprapatella targeting guide which should be used when the knee is in extension. However, prevention of the commonly encountered apex anterior andor valgus deformities remains a challenge when treating these injuries. The titanium tibial nail system royal childrens hospital. Orthopaedic implant design from concept to commercialization. Recently, suprapatellar nailing in the semiextended position has been suggested as a safe and effective surgical technique. The use of the percutaneous puncture technique allows the surgeon to. Surgical technique implant selection the trigen tan 71180884 and trigen fan 71180497 radiographic templates may be used to assist with preoperative implant selection.
Zimmer natural nail znn intramedullary system zimmer biomet. Jul 19 surgical diseases and hiv status in patients at central. Helps restore natural anatomic shape to fractured bones. The t2 distal tibial nail, available in 10mm diameter only, may be. The geometrical dimensions of the znn length 180 mm, diameter 10 mm. Zimmer natural nail system tibial nail surgical technique suprapatella table of contents product overview 2 implant overview 2 indications 2 contraindications 2 surgical technique 3 preoperative planning 3 patient positioning 3 reduction 3 starting point location 3 reaming 6 nail assembly and insertion 6 proximal screw placement 9 distal. Intramedullary nails can more reliably resist the relatively high axial forces. Phoenix tibial nail system featuring corelocktm technology. Femur interlocking nail matrix meditec znn cm surgical technique. Establishing an appropriate starting point is a crucial part of the surgical procedure. Flexible intramedullary nailing in children the nancy university. A text and atlas by roberto baran author, elvin zook author, m.
Trabecular metal natural cup system surgical technique. In this study demographic issue, type of the fracture, surgical technique and position of the proximal tip of the nail related to anterior knee pain following tibial nailing has been assessed. Historically, the most common surgical approaches position the knee in hyperflexion, including patellar tendon splitting pts and medial parapatellar mpp. Osteosynthesis in proximal humerus fracture plate or nail. Feb 15 treatment of fractures of the tibial plateau. Techniques for intramedullary nailing of proximal tibia fractures. For product details such as indications, contraindications, warnings and precautions please consult the ifu and surgical technique. Tamil free download as periya thirumozhi tamil pdf books pdf file. The zimmer natural nail tibia helps restore the natural anatomy of the tibia when treating tibial shaft fractures. The postoperative alignment seen in this nonmatched, consecutive series showed considerable improvement. Tavarez tavrow taylen taylor teal tebon tech technique technology teck ted. Providing locking options for all types of fractures, plus the advanced locking mode for increased rotational stability.
This study was conducted in a tertiary care centre in the department of plastic surgery, jipmer, pondicherry, india in the month of august 2019. However, prevention of the commonly encountered apex anterior andor valgus deformities r. Trace elements in human nutrition and health who world health. The tibial nail is designed to help treat various fractures of the tibia.
Pdf zimmer natural nail system tibia surgical technique. Apr 02, 2016 repeat corticotomy around a tibial nail requires one anterior incision for the medial and lateral cortices and one posteromedial incision for the posterior cortex. This intramedullary nail system offers nails in a variety of diameters and lengths to accommodate varying patient anatomy. Ender nailing for tibial shaft fractures sciencedirect. Orthopedic trauma zimmer natural nail system zimmer biomet. Titanium elastic nails for pediatric tibial shaft fractures. The use of a cannulated expert tibial nail with a large diameter offering more stability associated with the reamed technique is generally recommended for pseudarthroses. The second part describes in detail the techniques developed for each particular fracture type with the aid of numerous highquality illustrations. Trigen meta nail tibial nail system surgical technique. Mcglamrys comprehensive textbook of foot and ankle surgery. The use of a cannulated expert tibial nail with a large diameter offering more stability associated with the reamed technique is. Dec 12, 2015 statically locked, reamed intramedullary nailing remains the standard treatment for displaced tibial shaft fractures. Expert tibial nail surgical technique depuy synthes 11 3.
Im nails have long been used to treat fractures of long bones of the body. Hold the reamer steady in the same position in which the cup will be implanted approximately 45 of abduction and 15 of anteversion. Note as template magnification levels are set at 117%, all measurements are estimates of true size. Intramedullary nail fixation of distal tibia fractures. Surgical tips of intramedullary nailing nail repair gamma nail repair hip fracture m dn fem interlocking recon nail znn tibial nail surgical technique pdf a newly designed intramedullary nail with distal interlocking system for tibia fractures in s the clinical results. Despite poor early results with intramedullary nailing of extraarticular proximal tibia fractures, improvements in surgical technique and implant design modifications have resulted in more acceptable outcomes. Patient conditions weighed against the patients entire of noninflammatory degenerative joint evaluation. Oct 31, 2012 the definitive text in its field, mcglamrys comprehensive textbook of foot and ankle surgery, is the ideal reference for the podiatric or orthopedic surgeon, resident, or student preparing for certification exams. Role of bactiguard infection technology in preventing catheter.
The znn tibial nail system is a cannulated, intramedullary rod intended to restore the shape of the injured tibia to its preinjured state. Winner of first prize in orthopaedics and rheumatology at the 2008 british medical association medical book competition winner of association of american publishers best book in clinical medicine, 2007 this landmark multimedia reference presents the most current information on surgical treatments of a wide range of injuries, from complex pelvic. Establishing an appropriate starting point is a crucial part of the surgical. In addition to the t2 standard tibial nail that features options to address very proximal and very distal fractures as well as the advanced compression feature, there are two additional tibial nail design available on a special order basis that address specific surgical indications. Verify and confirm location under biplanar fluoroscopic guidance. The use of intramedullary nailing for the treatment of proximal metaphyseal tibia fractures is frequently followed by postoperative malalignment, whereas plate osteosynthesis is associated with. In method a, which is used for the proximal onethird fractures of the tibia, the nails are inserted from the distal tibia medially and laterally towards the proximal tibia. Surgical approaches to intramedullary nailing of the tibia. A more distal entry point may result in damage to the posterior cortex during nail insertion. Surgical technique phoenixtm tibial nail system featuring corelocktm technology each nail features corelocktm technology, 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. Flexible intramedullary nailing in children the nancy. Zimmer natural nail system tibia surgical technique. This educational video presents a surgical technique for placement of an intramedullary tibial nail for a tibia shaft fracture through a.
Abstract book 20th asia pacific orthopaedic association. For nail sizes 811 mm, the proximal diameter is 11. Generally, a nail diameter 1 mm less than the final reamer diameter is chosen. Select a transpatellar incision to approach the tibial nail insertion entry point. The t2 tibial nailing system is intended to provide temporary stabilization of various types of fractures, malunion and nonunion of the tibia. Postoperative knee pain is common following intramedullary nailing of the tibia, regardless of surgical approach, though the exact source is controversial. This softtissuesparing method of fracture fixation achieves biomechanical stabilization of the fracture using a loadsharing device that allows for.
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