Implants trauma Flexible Children Nail

1. Introduction P. 5 Preface P. 6 Screw P. 6 Properties P. 7 Indications & Contraindications P. 8 Biomechanics 2. Surgical Technique P. 9 Instruments P. 9 Presurgical P. 10 Surgical Technique P. 11 Postoperative treatment P. 11 Explantation P. 11 Summary 3. Information P. 13 Order list P. 16 Reconditioning Manual P. 18 Notes

Preface Over the last years, the elastic, yet stable medullary fixation of shaft fractures in children has become standard when treating diaphyseal fractures. Paediatric nails have been modified to match conditions in children and are now available in different lengths and diameters.

61273-100 Spiral Drill, D=2.7mm, L=l00mm, AO Connector conic, self-holding ♦ Elastic, yet stable fracture fixation ♦ Small skin incision ♦ Implant insertion at a side distant to the fracture (closed procedure) ♦ Fracture haematoma is left untouched (healing) ♦ Short hospital stay ♦ Distal lock for increased stability possible ♦ Version with loop and hook

Indications & Contraindications Indications: • Ideal in cases of easily stabilisable fractures such as transverse or short oblique fractures of the medial diaphyseal area. • Also suitable for borderline indications in difficultly stabilisable fractures, long oblique fractures, rotation or fragmented fractures, at least of the upper extremity. • Pathologically benign fractures (e.g. juvenile bone cysts) Contraindications: • Pathological fractures without identification of the malignant/benign character, particulary in cases of malignant tumours • Existing infections in the fracture zone and operation...

Biomechanics • The principle of the paediatric medullary nail is based on an “elastic, yet stable fixation”. • Due to the tolerance of the medullary nail to micro-movement, forces causing thrust and shear that may have negative impact on fracture healing will mainly be transformed into axial powers beneficial for fracture healing (pressure and traction). • Due to early movement (muscle tension) and weight-bearing, such positive powers will even be enhanced. As a consequence, rapid fracture consolidation based on extensive callus formation is observed. • Locking for increased stability is possible,...

Instruments • The instruments are used to introduce the nails of different lengths (13 - 14cm) and diameters (2.0mm, 2.5mm, 3.0mm, 3.5mm and 4.0mm) into the medullary cavity. • The instruments provide easy handling, comply with needs of shaft fracture treatment in children and thus allow for rapid and profound repair. Presurgical • The patient is positioned with the leg isolated and covered with drapes (or on an extension table) using at least one fluoroscopy in order to display both planes simultaneously. • Identification of the nail length is either performed using the fluoroscopy under consideration...

Surgical Technique • After skin incision, soft tissue is bluntly separated and then the drilling hole is established with the nail being carefully introduced into the created opening. • Using the awl, the drilling hole is established above the epiphysis maintaining a distance that allows for additional locking above the epiphyseal plate. • Perform the same procedure on the other side. • Then, both nails are being successively introduced beyond the fracture gap under fluoroscopy guidance. • In femoral fractures: • The medial nail is anchored in the femoral neck, the lateral nail under the greater...

Postoperative treatment • Mobilization with forearm crutches, while increasing weight-bearing (depending on pain). Explantation After 6-9 months (depending on age and fracture), the material is removed using appropriate removal instruments. Retraction hook Summary The elastic stable feather nail is the ideal paediatric medullary nail when repairing shaft fractures in growing bones. Due to implant insertion at a distant site, the fracture can be stabilized without impairment of the periosteum or the fracture haematoma. The 3-point support offers sufficient stability. The optional distal lock prevents...

Order list Children‘s Nail, D=2.0mm, L=130mm, with hook Children‘s Nail, D=2.0mm, L=140mm, with hook Children‘s Nail, D=2.0mm, L=150mm, with hook Children‘s Nail, D=2.0mm, L=160mm, with hook Children‘s Nail, D=2.0mm, L=170mm, with hook Children‘s Nail, D=2.0mm, L=180mm, with hook Children‘s Nail, D=2.0mm, L=190mm, with hook Children‘s Nail, D=2.0mm, L=200mm, with hook Children‘s Nail, D=2.0mm, L=210mm, with hook Children‘s Nail, D=2.5mm, L=150mm, with hook Children‘s Nail, D=2.5mm, L=160mm, with hook Children‘s Nail, D=2.5mm, L=170mm, with hook Children‘s Nail, D=2.5mm, L=180mm, with hook Children‘s...

Spiral Drill, D=2.7mm, L=100mm, AO Connector Sterilization Tray, Children‘s Nail, Implants Sterilization Tray, Children‘s Nail, Instruments

Reconditioning Manual The information below should help you in reconditioning medical devices. IMPORTANT INDICATIONS FOR DOCTORS & OPERATING THEATRE PERSONNEL This instruction leaflet refers to all supplied non-sterile implants and all reusable instruments from I.T.S. GmbH. Detailed information for the identification of the product (such as system classification, cat. no.) can be found in the product identification code and/ or on the packaging label. Make sure that you are familiar with the possible application, combinability and correct handling of the product. Please note that product systems...

Manual disinfection If a cleaning agent without a disinfectant effect is used, separate disinfection must be carried out after manual cleaning. (Order: Decontamination for staff protection, cleaning, disinfection). Equipment: Commercially available disinfectant authorised for use with medical products from the VAH list. Manufacturer‘s information, e.g. concerning concentration, temperature and exposure time should be followed. The steps described in the table above also apply. Patient Information Implantation has consequences for the discomfort, mobility and general life circumstances of the...