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Learn the Tibial intramedullary nail ( suprapatella approach ) : Synthes Expert Tibial Nail surgical technique with step by footprint instructions on OrthOracle. Our e-learning chopine contains high resolution images and a certify CME of the Tibial intramedullary pinpoint ( suprapatella approach ) : Synthes Expert Tibial Nail surgical routine .
There are assorted ways to manage tibial fractures in general and compound tibial fractures in especial. Where the local expertness exists the council of perfection involves collaborative management by Orthopaedic surgeons and their plastic surgical colleagues. open fractures should be managed according to the british Orthopaedic Association ( BOA ) & British Association of Plastic, Reconstructive & Aesthetic Surgeons ( BAPRAS ) Audit Standards for Trauma [ BOAST – Open Fractures ; December 2017 ].
We present the case of an isolated open tibial diaphyseal fracture that has been stabilised with an Expert Tibial Nail. In a compound Ortho-Plastic approach path, the wreathe is debrided and washed out anterior to making a overtone medial fasciotomy incision. Through this break incision, the cram ends are delivered, debrided, washed out and the wounds then closed chiefly. The fracture is held and reduced with the Staffordshire Orthopaedic Reduction Machine ( STORM – designed and distributed by Metaphysis ) and then a suprapatella tibial breeze through is performed .
A late meta-analysis [ Wang et alabama 2018 ] suggested that electric potential advantages of the suprapatella approach for tibial complete might include shorter fluoroscopy time, reduced knee pain and improved knee recovery angstrom well as more accurate fracture reduction compared to the more coarse approaches .
The Expert Tibial Nail from Depuy Synthes is a titanium admixture pinpoint which has advanced proximal and distal lock options that assist in the control and stabilization of difficult fault patterns. This allows either very proximal or very distal fractures to be controlled. Distally there is besides a screw angle specifically for Tillaux type fracture fragments. Proximally there are besides cancellate locking bolts that give enhanced bone buy in this region. The interpolation of an end cap locks the most proximal engage bolt and converts the pinpoint / proximal locking thunderbolt into a fix angle construct. Depuy technical nails are available as both solid and cannulate nails. importantly the musket ball tipped lead electrify will pass through the nail, so that it doesn ’ t have to be exchanged after reaming and anterior to nail interpolation. For suprapatella nailing the like nails are used which means no extra implants are required ( though there is a different interpolation handle and orchestration tray ).
Author: Mr Ross Fawdington FRCS Ed (Tr & Orth).
Institution: Queen Elizabeth Hospital, Birmingham, UK.
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