The expert tibial nail etn is standard in treating tibial fractures with a wide range of indications. Class 2 device recall synthes tibial nail wrap holds 11 nails. Oct 20, 2009 the results showed lower risks of tibial fracture nonunion and implant failures with reamed nails compared to unreamed nails in closed tibial fractures relative risk rr. Synthes for the stabilization of metaphyseal fractures, new intramedullary tibial implants have been. Titanium cannulated tibial nail surgical technique depuy synthes 1. It is cost effective with short hospital stay and facilitates earlier return to work. Unreamed technique reamed technique nail selection 15 nail insertion 16. Depuy timax synthes cpti4 synthes ss 316l 0 2000 4000 6000 8000 0 4. All surgical techniques are available as pdf files at. A series of 23 patients with tibial shaft fractures, 12 open and 11 closed, were treated using a utn unreamed tibial nail technique. A new angle stable nailing concept for the treatment of distal tibia. Surgical treatment of distal tibial fractures demands a stable fracture fixation. 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.
Fatigue strength of common tibial intramedullary nail distal. Stability of reamed and unreamed intramedullary tibial. Premature failure of either the nail andor locking screws with unstable fracture patterns may lead to angulation, shortening, malunion, and im nail migration. They analysed their results in detail and showed no significant difference in the incidence of compartment syndrome, infection, malunion, or patient function. Reamed versus unreamed nail in the treatment of tibia shaft. Introduction expert tibial nail 2 ao principles of internal fixation 4 surgical. Effect of locking plate fixation vs intramedullary nail. Expert tibia nail depuy synthes pdf catalogs technical. 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. Ma721 mr0 f1 510k summary of safety and effectiveness. Controversies in the intramedullary nailing of proximal.
Longterm stability of anglestable versus conventional. Analysis of delayed fracture healing following unreamed. Ufncfn unreamedcannulated femoral nail indications for ufncfn locking the nail must be inserted carefully so as to limit the distraction on the fractured side healing promotion. Distal locking screws for intramedullary nailing of tibial. Solid humeral nail uhn and proximal humeral nail phn. Intramedullary nailing of proximal third tibial fractures. Learn about the expert tibial nail with protect coating, a tool offering a variety of locking options that enable tailoring of fixation to the fracture pattern. This is best achieved by striking back the distally. Retrograde nailing of the femur using an intercondylar appro.
Expert tibial nail surgical technique depuy synthes 1. We prospectively studied 44 patients treated with the ao unreamed tibial nail utn at two orthopaedic trauma units. Different techniques for reduction of these fractures are available and can be applied with either fixation device. The unreamed nailbone construct was less stable than the reamed construct. There were 103 patients with 104 tsf enrolled in the study within the period from december 2005 to june 2010. Up to thirty percent of all unreamed nail locking screws can break after initial weight bearing is allowed at 810 weeks if union has not occurred. Percutaneous rotational osteotomy of the femur utilizing an intramedullary rod percutaneous rotational osteotomy of the femur utilizing an intramedullary rod. Before proximal locking, care should be taken that the fracture is not distracted. The t2 femoral nailing system is the realization of excellent biomechanical intramedullary stabilization. Pdf unreamed interlocking nailing in open fractures of tibia. Clinical experience has demonstrated the performance and safety of the two intramedullary nails featuring the protect coating. Unreamed solid locked nailing in the treatment of compound.
Stability of reamed and unreamed intramedullary tibial nails. Patients were treated with intramedullary nails and blocking screws. If the nail does not pass easily, it may be adequate to enlarge the medullary canal with the hand reamer 351. Factors of injury severity, course of surgery and hospitalization, and incidence. Fractures of the proximal third of the tibial shaft treated.
Comparison of outcome in reamed vs unreamed nailing in the. The primary problem this presents is hardware removal during revision surgery. Computational comparison of reamed versus unreamed. Reamed versus unreamed nail in the treatment of tibia. Go search hello select your address best sellers customer. This is a prospective study based on 30 cases of compound tibial diaphyseal fractures fulfilling our inclusion criteria and stabilised with primary unreamed solid ao tibial locked nailing with a follow up ranging. Determine the nail length by the above procedure on the uninjured leg or before draping nonsterile or compare the length of two identical synream reaming rods b 2. The curved proximal nail end determines the angle of insertion for the guide wire.
Recently we have become aware of a few cases of nonunion developing in fractures treated with the unreamed nail, and one contributory factor might be excessive motion at the fracture site. Expert tibial nail surgical technique depuy synthes 11 3 confirm nail length and diameter instrument 03. Titanium cannulated tibial nail expert nailing system. The delta reconstruction nail richards, memphis, tn 1 patient and the universal femoral nail synthes, paoli, pa, 8 patients were the implants initially used at the start of the study. They randomized 94 patients with 96 fractures to treatment with either a reamed goose kempf nail or an unreamed delta nail. Synthes urtn unreamed tibial nail insertion and titanium. Used synthes titanium unreamed femoral nail specialty locking.
The aoasif unreamed femoral nail ufn the basics synthes bulletin no. Class 2 device recall synthes tibial nail wrap holds 11. The unreamed nail is associated with a lessened risk of infection 12, perhaps due to the preservation of medullary vasculature. Various keating et al17 carried out a prospective trial. Synthes urtn unreamed tibial nail insertion and titanium locking set 105. Synthes titanium unreamed femoral nail specialty locking set free. 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. To study the accuracy of these templates, we randomly selected 100 femoral and 100 tibial radiographs taken after stabilisation by an intramedullary nail using a standard technique. Between june 1999 and may 2000, a total of 60 cases of open tibial shaft fractures were operated on with unreamed interlocking nails at safdarjung hospital, new delhi, india.
Insert the nail until the nail tip protrudes only slightly into the humeral head. Surgical management of compound fracture tibia using an. Extending the indications of intramedullary nailing with the. Used synthes titanium unreamed femoral nail specialty. Oct 15, 20 the aim of the prospective randomized study was to compare the results of the treatment of tibia shaft fractures tsf by reamed or unreamed intramedullar nail. Pdf reamed versus unreamed nail in the treatment of. For general guidelines, function control and dismantling of multipart instruments. Synthes 5 indications the expert tibial nail 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. Bonemineral density correlated well with bone strength r 0. Extending the indications of intramedullary nailing with.
Two or three bolts serve for distal locking of the nail, and may pass across the vertical intraarticular fracture site and create an interfragmentary fixation as. A new angle stable nailing concept for the treatment of distal tibia fractures. Pdf unreamed intramedullary locking nailing for open tibial. Intramedullary nailing is the standard treatment for most patients with fractures of the tibial shaft. Position the carm for an ap view of the distal tibia. The distal location of the herzog bend of this older unreamed synthes tibial nail caused posterior and distal displacement of the shaft segment during nail insertion. The implants differ in their design slottedunslotted, solid cannulated, small diameterlarge diameter, static locking. Pdf reamed versus unreamed nail in the treatment of tibia. The distal segment can be stabilized by using the two ml locking options of the tibial nailex. Results fortyeight patients with 49 tsf were treated by unreamed tibial nail. The functional results of tibial shaft fractures treated with intramedullary nail compressed by proximal tube.
As a first result the proximal tibial nail ptn, synthes was designed and clinical investigation was started in 1999. Fatigue strength of common tibial intramedullary nail. Biomechanical comparison of distal locking screws for distal. The unreamed tibial nail in the treatment of distal. Extending the indications of intramedullary nailing with the expert. Titanium cannulated tibial nail surgical technique depuy synthes 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. Newer generation intramedullary im tibial nails provide several distal interlocking screw options. Pdf intramedullary nailing without interlocking screws for femoral. Expert nailing system titanium cannulated tibial nail.
Insert the guide wire for approximately 8 cm10 cm and check the position under image intensification in the ap and lateral views. Overall outcomes appear to be nearly equivalent, with minor differences in complications. The remaining 44 patients were all treated with the unreamed femoral nail synthes, used in either a static or dynamic mode depending on the. Ufn unreamed femoral nail cfn cannulated femoral nail. Comparison of outcome in reamed vs unreamed nailing in. The nails have been designed for specific applications to help restore the shape of the fractured bone to its natural, preinjured state. Tibial nail tense nail tense nail external fixator footfoot. Unreamed solid locked nailing in the treatment of compound diaphyseal fractures of tibia. The use of blocking screws with internal lengthening nail and reverse rule of. Ut nctn solid cannulated tibial nail indications for tibial nailing increase in weightbearing if painfree or evidence of callus formation, at the latest after 6 weeks increasing to full weightbearing if painfree if evidence of callus formation, not before 12 weeks if painfree increasing to full weightbearing if painfree and. The nail was 9 mm in diameter in 16 cases and 8 mm in 7 cases. Unreamed intramedullary locking nailing for open tibial fractures article pdf available in international orthopaedics 222. Expert tibial nail surgical technique depuy synthes 5 indications the expert tibial nail 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.
Randomized trial of reamed and unreamed intramedullary. Consult depuy synthess entire expert tibia nail catalogue on medicalexpo. Over all morbidity is reduced and better patient satisfaction noted. Valgus and apex anterior malalignment and anterior displacement of the proximal fragment are the most common. Furthermore, the development of the t2 femoral nailing system offers the competitive advantages of.
Fractures of the proximal third of the tibial shaft. Synthes unreamed humeral nail ruler if the item is subject to fda regulation, i will verify your status as an authorized purchaser of this item before shipping of the item. The alignment of fractures was determined using standard anteroposterior and lateral radiographs after surgery and at each followup examination. Ctncannulated tibianai system is a universal straight lntramedullaryim nai with a 50 proximal and distal bend configuration to fit the anatomy of the tibia and is inserted proximallyantegrade over 3. Distally, the expert tibial nail can be locked with two ml locking screws see illustrations. Failures of intramedullary tibial nails applied without reaming, clin. Synthes titanium cannulated tibial nail expert system 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. Biomechanical comparison of distal locking screws for.
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. Critical analysis of tibial fracture healing following. Pdf unreamed nailing of tibial fractures with the solid. Pdf accuracy of intramedullary templates in femoral and. The mean followup time was months range 624 months. We examined the correlation of bone mineral density and bone strength in the cadaver tibia, and looked in vitro at the relative stability of tibial fractures fixed with either reamed or unreamed libial nails. It has biological and biomechanical tibia diaphysial fracture. A literature search was performed using pubmed, ovid and quosa to identify studies performed using etn protect.
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