LOCKING TITANIUM ELASTIC PIN
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LOCKING TEP LOCKING TITANIUM ELASTIC PIN INTRAMEDULLARY NAIL

Introductions Index Features Indicatiıons Surgical Technique Femoral Surgical Technique Tibial Surgical Technique Ulna Radius Surgical Technique Humeral Surgical Technique Removing of the Implant Implants & Instruments Radiographic Cases Locking TEP (titanium elastic pin) has been developed to take advantage of more than the titanium elastic pin by giving slope to the front the elastic intramedullary nail system to improve stability and providing easy of application. Axial and rotational stability are increased by locking with the grooved hill of nail located in the fixing hole in the end...

Features L-TEP is produced with Ti6Al7Nb alloy suitable with ASTM F 1295/ISO 5832-11 standard and it has flexible capabilities reverted back after bending for different degrees. The system is available in two different sets of nails located; 2.0-2.5-3.0-3.5 mm a set of small nails, major ones 4.0-5.0 mm. Straight and front slope nails are placed in the set having lengths of 200-250-300-350 and 400 mm. It is designed inclined both end parts of the front beveled to provide easy application and comfortable detection interior through broken line in order to improve stability. It is formed as...

Another feature offered by the system is no need to form the nails during the operation with the previously shaped nails. This feature significantly shortens the operation time. It is an advantage that there is also straight form of nails in the set container allowing the user bending or curving the L-TEP according to operation requirements. There are two different types of this special curved L-TEP as lateral and medial As known elastic nails are generally applied with in pairs. Lateral nail placed in the set container is used in the double nailing application by fixing the nails opposite...

Surgical Techique Pre-operative planning must be done carefully. Input point of nail and final location of the end part have to be placed out of the articular capsule for the protection of epiphysis and epiphyseal plate and can vary according to the anatomical region to be applied Example surgical technique: Standard technique applied for femoral transverse shaft fractures can be based as a beginning. Femoral Surgical Technique NAIL ENTRY POINT AND OPENING OF THE MEDULLARY CANAL:The narrowest part of the medullary canal is measured and nail diameter has to be one-third of it. Reduction is...

INSERTING THE NAIL: Under favour of the Nail Inserter last part of nail can be implemented and providing the right position of the nail without the necessity of fluoroscopy. The nail is inserted into the open medullary canal as close as possible to the fracture line. Second nail is inserted like the first one. The first cross encounter of the nails is provided on the metaphyseal region. First nail is transmitted by hand or Hammer to the fracture line. Impactor-Extractor Rod can be used during the process. Second nail is transmitted like the first nail. Fracture reduction can be done by...

THE FINAL POSITION OF THE NAIL: Final stabilization is made in that ways 2 cm distal to proximal epiphys line with the help of fluoroscopy control of nail position. At this step, the Nail Inserter is taken out. Provide the nail dive in cortex with the help of Final Impractor with the slight strikes of hammer. THE IMPLEMENTATION OF THE LOCKING SCREW OF THE NAIL: Drill with Bone Drill with constant angle by installing the Threaded Drill Sleeve to lock the hole of the nail.

Length of screw is determined with the Depth Gauge. The appropriate locking screw is inserted through the nails locking hole with a Screwdriver to fix the nails. The operation is terminated by the suture of the incision area.

LATERAL AND MEDIAL NAILING TECHNIQUE: Monolateral application method is preferred in fracture of femoral diaphysis close to distal and fracture of distal metaphysis. This technique is different from the shaft fracture fixation technique. Entrance area is opened approximately 1.5 cm from the antero-lateral of the subthrocanteric area longitudinally for the first nail. Second nail is inserted 1 cm lateral to the first nail’s entry point with the same principle as the first one. Medial nail is used to provide support in the medullary canal at the level of fracture. First and second nail are...

Ulna Radius Surgical Technique Just one nail is inserted individually in the radius and ulna intramedullary applications because both bones generate one unit. A single nail is used on both radius & ulna to fill 60% of the medullary canal. It is recommended that the nail should always be placed in a retrograde approach on the radius to avoid the risk of damage to the radial nerve which is close to elbow joint Entry point is determined at the proximal of radial steloid or on the lister tubercul (from approximately 1 cm proximal of physis) for radius diaphysis fractures. Incision is made in...

Removing of the Implant Locking screw is removed with a screw driver compatible with locking screw of the nail. Screw is pulled to the surface of the bone outwardly locking nail is inserting of extract hook with the screw hole. It can be used as shown in figure above with Impractor-Extractor Rod, the rear portion of the hook in the meantime. All of the nail is pushed out of the bone with Impractor-Extractor Rod and slightly strikes of Hammer, Nail Inserter is inserted the section once taken out of the bone 2.5 cm section of the end of nails.

Implants & Instruments 2.0-2.5-3.0-3.5 mm Locking TEP 1. DESIGN TRAY LOCKING TI ELASTIC PIN (M-TEP) 3.5X200 MM LOCKING TI ELASTIC PIN (M-TEP) 3.5X250 MM LOCKING TI ELASTIC PIN (M-TEP) 3.5X300 MM LOCKING TI ELASTIC PIN (M-TEP) 3.5X350 MM LOCKING TI ELASTIC PIN (M-TEP) 3.5X400 MM LOCKING TI ELASTIC PIN (L-TEP) 3.5X200 MM LOCKING TI ELASTIC PIN (L-TEP) 3.5X250 MM LOCKING TI ELASTIC PIN (L-TEP) 3.5X300 MM LOCKING TI ELASTIC PIN (L-TEP) 3.5X350 MM LOCKING TI ELASTIC PIN (L-TEP) 3.5X400 MM LOCKING TI ELASTIC PIN (STRAIGHT) 3.5X400 MM