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. Pdf unreamed intramedullary locking nailing for open tibial. 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. Stability of reamed and unreamed intramedullary tibial. Pdf reamed versus unreamed nail in the treatment of. Synthes for the stabilization of metaphyseal fractures, new intramedullary tibial implants have been.
Percutaneous rotational osteotomy of the femur utilizing an intramedullary rod percutaneous rotational osteotomy of the femur utilizing an intramedullary rod. Distally, the expert tibial nail can be locked with two ml locking screws see illustrations. Expert nailing system titanium cannulated tibial nail. Titanium cannulated tibial nail surgical technique depuy synthes 1. They analysed their results in detail and showed no significant difference in the incidence of compartment syndrome, infection, malunion, or patient function. Overall outcomes appear to be nearly equivalent, with minor differences in complications. Retrograde nailing of the femur using an intercondylar appro. A new angle stable nailing concept for the treatment of distal tibia fractures. Premature failure of either the nail andor locking screws with unstable fracture patterns may lead to angulation, shortening, malunion, and im nail migration.
Used synthes titanium unreamed femoral nail specialty locking. The t2 femoral nailing system is the realization of excellent biomechanical intramedullary stabilization. The nail was 9 mm in diameter in 16 cases and 8 mm in 7 cases. 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. Distal locking screws for intramedullary nailing of tibial. Different techniques for reduction of these fractures are available and can be applied with either fixation device.
Unreamed technique reamed technique nail selection 15 nail insertion 16. Intramedullary nailing is the standard treatment for most patients with fractures of the tibial shaft. Unreamed solid locked nailing in the treatment of compound diaphyseal fractures of tibia. Analysis of delayed fracture healing following unreamed. If the nail does not pass easily, it may be adequate to enlarge the medullary canal with the hand reamer 351. 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. Biomechanical comparison of distal locking screws for distal.
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. The curved proximal nail end determines the angle of insertion for the guide wire. The use of blocking screws with internal lengthening nail and reverse rule of. Newer generation intramedullary im tibial nails provide several distal interlocking screw options. Computational comparison of reamed versus 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. Before proximal locking, care should be taken that the fracture is not distracted. 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. 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. Expert tibial nail surgical technique depuy synthes 1. Extending the indications of intramedullary nailing with the. A literature search was performed using pubmed, ovid and quosa to identify studies performed using etn protect.
The expert tibial nail etn is standard in treating tibial fractures with a wide range of indications. It has biological and biomechanical tibia diaphysial fracture. Pdf intramedullary nailing without interlocking screws for femoral. Solid humeral nail uhn and proximal humeral nail phn. Comparison of outcome in reamed vs unreamed nailing in. The unreamed nailbone construct was less stable than the reamed construct. The unreamed tibial nail in the treatment of distal. 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. Randomized trial of reamed and unreamed intramedullary.
Effect of locking plate fixation vs intramedullary nail. Failures of intramedullary tibial nails applied without reaming, clin. 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. We prospectively studied 44 patients treated with the ao unreamed tibial nail utn at two orthopaedic trauma units. Consult depuy synthess entire expert tibia nail catalogue on medicalexpo. Factors of injury severity, course of surgery and hospitalization, and incidence. The remaining 44 patients were all treated with the unreamed femoral nail synthes, used in either a static or dynamic mode depending on the. Surgical management of compound fracture tibia using an. Extending the indications of intramedullary nailing with the expert.
Fatigue strength of common tibial intramedullary nail distal. Ufn unreamed femoral nail cfn cannulated femoral nail. Reference chart synthes usa 2 wrights lane east west chester, pa 19380. The aoasif unreamed femoral nail ufn the basics synthes bulletin no. Reamed versus unreamed nail in the treatment of tibia. 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. Extending the indications of intramedullary nailing with. As a first result the proximal tibial nail ptn, synthes was designed and clinical investigation was started in 1999. Synthes titanium unreamed femoral nail specialty locking set free. Class 2 device recall synthes tibial nail wrap holds 11 nails. Clinical experience has demonstrated the performance and safety of the two intramedullary nails featuring the protect coating.
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. Critical analysis of tibial fracture healing following. Pdf unreamed nailing of tibial fractures with the solid. Patients were treated with intramedullary nails and blocking screws. Furthermore, the development of the t2 femoral nailing system offers the competitive advantages of. 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. 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. Insert the guide wire for approximately 8 cm10 cm and check the position under image intensification in the ap and lateral views. Fractures of the proximal third of the tibial shaft.
Longterm stability of anglestable versus conventional. Over all morbidity is reduced and better patient satisfaction noted. Biomechanical comparison of distal locking screws for. 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. A series of 23 patients with tibial shaft fractures, 12 open and 11 closed, were treated using a utn unreamed tibial nail technique. 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.
The implants differ in their design slottedunslotted, solid cannulated, small diameterlarge diameter, static locking. 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. Pdf accuracy of intramedullary templates in femoral and. Fractures of the proximal third of the tibial shaft treated. The unreamed nail is associated with a lessened risk of infection 12, perhaps due to the preservation of medullary vasculature. Titanium cannulated tibial nail expert nailing system. 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. 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. Fatigue strength of common tibial intramedullary nail.
For general guidelines, function control and dismantling of multipart instruments. Results fortyeight patients with 49 tsf were treated by unreamed tibial nail. The metaphyseal portion was stabilized to the tibial diaphysis with the unreamed tibial nail and static distal interlocking was achieved with 3. The primary problem this presents is hardware removal during revision surgery. Ma721 mr0 f1 510k summary of safety and effectiveness. The nails have been designed for specific applications to help restore the shape of the fractured bone to its natural, preinjured state. Bonemineral density correlated well with bone strength r 0. Class 2 device recall synthes tibial nail wrap holds 11. Position the carm for an ap view of the distal tibia. Reamed versus unreamed nail in the treatment of tibia 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. Unreamed intramedullary locking nailing for open tibial fractures article pdf available in international orthopaedics 222. Go search hello select your address best sellers customer. Pdf unreamed interlocking nailing in open fractures of tibia.
Stability of reamed and unreamed intramedullary tibial nails. Pdf reamed versus unreamed nail in the treatment of tibia. Unreamed solid locked nailing in the treatment of compound. Insert the nail until the nail tip protrudes only slightly into the humeral head. Depuy timax synthes cpti4 synthes ss 316l 0 2000 4000 6000 8000 0 4. Controversies in the intramedullary nailing of proximal. The functional results of tibial shaft fractures treated with intramedullary nail compressed by proximal tube. Synthes urtn unreamed tibial nail insertion and titanium locking set 105. A new angle stable nailing concept for the treatment of distal tibia. There were 103 patients with 104 tsf enrolled in the study within the period from december 2005 to june 2010.
Comparison of outcome in reamed vs unreamed nailing in the. The distal segment can be stabilized by using the two ml locking options of the tibial nailex. There were 14 type a, 26 type b and four type c fractures ao classification, muller. Expert tibial nail surgical technique depuy synthes 11 3 confirm nail length and diameter instrument 03. Various keating et al17 carried out a prospective trial. Expert tibia nail depuy synthes pdf catalogs technical. The mean followup time was months range 624 months. Tibial nail tense nail tense nail external fixator footfoot.
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. The alignment of fractures was determined using standard anteroposterior and lateral radiographs after surgery and at each followup examination. Ufncfn unreamed cannulated femoral nail indications for ufncfn locking the nail must be inserted carefully so as to limit the distraction on the fractured side healing promotion. 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. All surgical techniques are available as pdf files at.
It is cost effective with short hospital stay and facilitates earlier return to work. Valgus and apex anterior malalignment and anterior displacement of the proximal fragment are the most common. Synthes tibial nail wrap holds 11 nails and synthes intramedullary nail wrap holds 10 nails. They randomized 94 patients with 96 fractures to treatment with either a reamed goose kempf nail or an unreamed delta nail. 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. 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. 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. Synthes urtn unreamed tibial nail insertion and titanium. This is best achieved by striking back the distally. Introduction expert tibial nail 2 ao principles of internal fixation 4 surgical. Surgical treatment of distal tibial fractures demands a stable fracture fixation. Randomized implant failure where they noted a 7% incidence trial of reamed and unreamed intramedullary nailing of of screw breakage in the reamed nails, compared tibial shaft fractures.
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