Intramedullary Locked Nailing With Screws for Tibia Fractures Solid/Cannulated Surgical Technique Cannulated Tibial Interlocking Nail Intramedullary Nail System Tibia Nail Kit Code 08060001

Intramedullary locked Nailing With Screws for Tibia Fractures Solid/Cannulated www.arzzt.com Intramedullary Nail System

Intramedullary locked Nailing With Screws for Tibia Fractures Solid/Cannulated www.arzzt.com The purpose of this guide is to demonstrate the technique and recommended indications for the use of ARZZT Intramedullary Nails in the treatment of diaphyseal tibia fractures. The recommendations for their use do not presume to interfere with the surgeon’s experience, nor the particular needs of each patient, and follow the basic norms for the treatment of diaphyseal fractures through fixation with locked intramedullary nails. Intramedullary Nail System 3

Intramedullary locked Nailing With Screws for Tibia Fractures Solid/Cannulated www.arzzt.com Introduction Currently, nearly all authors agree on intramedullary nailing as the treatment of choice for the majority of tibia fractures, thanks to its biological and biomechanical advantages. The locked nail acts biomechanically as a “bridge osteosynthesis,” with good stability in terms of flexion and rotation. With more proximal and distal fractures, or more complex fractures, its fixation depends on the locking screws, and much less on bone-nail friction. This is why Truemed has developed its solid...

Intramedullary locked Nailing With Screws for Tibia Fractures Solid/Cannulated www.arzzt.com Indications : Ins Hilden Arzzt Nail Systems, consisting of intramedullary solid and cannulated nails, end cap and locking screws, are intended for fixation of fractures of different types: of the shaft, open and closed shaft fractures; and malunion and non-unions of the Femur, Tibia, and Humerus. Cannulated nail: - Tibia fracture classifications 42-A, 42-B, and 42-C (AO) - Exposed tibia fractures I, II, and IIIA (Gustilo) - Non-union or pseudoarthrosis of the tibia Contraindications: - Infections - Open...

Intramedullary locked Nailing With Screws for Tibia Fractures Solid/Cannulated www.arzzt.com Implant Design Cannulated tibia nail Material: TITANIUM 6AI4V Available in the following measurements: With increments of 20 mm of longitude for all diameters. • Diameter 8 mm with a longitude of 240 mm to 340 mm • Diameter 9 mm with a longitude of 260 mm to 360 mm • Diameter 10 mm with a longitude of 280 mm to 360 mm Diameter of cannulated orifice: 3.7 mm Diameter of guide wire: 2.5 mm, longitude of 1,000 mm Titanium locking screws: 30 mm to 80 mm, with increments of 5 mm Intramedullary Nail Syste

Intramedullary locked Nailing With Screws for Tibia Fractures Solid/Cannulated www.arzzt.com Implant Design Solid tibia nail: This is a solid nail that requires a manual reamer from the site of introduction to the tibial isthmus, which needs to be one millimeter larger in diameter than the nail used. Available in the following measurements: With increments of 20 mm for each longitude: • Diameter 8 mm with a longitude of 240 mm to 340 mm • Diameter 9 mm with a longitude of 260 mm to 360 mm • Diameter 10 mm with a longitude of 280 mm to 360 mm The nail is made of TITANIUM 6AI4V Intramedullary Nail...

Intramedullary locked Nailing With Screws for Tibia Fractures Solid/Cannulated www.arzzt.com Intramedullary Nail System 8

Intramedullary locked Nailing With Screws for Tibia Fractures Solid/Cannulated www.arzzt.com Surgical Planning The diameter and longitude of the nail are determined based on the measurement of X- rays of the healthy extremity, taking into account the image magnification standards (which varies between 10 and 15 percent). Another method is the measurement in the healthy extremity of the distance between the anterior tuberosity of the tibia and the articulation of the ankle, subtracting 20 mm from the longitude obtained. Intramedullary Nail System 9

Intramedullary locked Nailing With Screws for Tibia Fractures Solid/Cannulated www.arzzt.com System Calibration (for both system): Attach the cannulated or solid nail to the insertion handle, aligning its tabs with the grooves of the implant, holding it firmly by the nail connector. Secure the system using the L-handled hexagon key (Allen). Place the proximal arm over the insertion handle, ensuring that the longitude arrow for the selected nail meets the arrow located on the handle. Fasten the tibia module to the handle by tightening the fastening screw with the L-handled hexagon key (Allen)....

Intramedullary locked Nailing With Screws for Tibia Fractures Solid/Cannulated www.arzzt.com Insert the T-handled feeler gauge into the 5.2 mm external sheath (for tissue protection) Place the distal arm, fastening it to the proximal arm with the fastening screw, using the L-handled hexagon key (Allen). Introduce the external tibia sheaths (for tissue protection) to the distal arm, along with the internal sheaths (3.5 mm drill bit guides). Intramedullary Nail System 11

Intramedullary locked Nailing With Screws for Tibia Fractures Solid/Cannulated www.arzzt.com Make sure that the bits pass freely through the nail’s distal orifices. Once the system is calibrated, remove the spacer, the T-handled feeler gauge, and the 5.2 mm external sheath, as well as the other external sheaths and the internal sheaths (3.5 mm drill bit guides). Detach the module from the fastener handle, leaving it in two pieces: a) Insertion handle with the nail and b) module with the distal arm. Intramedullary Nail System 12

Intramedullary locked Nailing With Screws for Tibia Fractures Solid/Cannulated www.arzzt.com Surgical Technique The surgical technique described as follows is used for the placement of both implants, with the variants for the insertion of each particular nail specified. Patient positioning: Place the patient in a prone supine position with the knee of the injured extremity flexed at 70 to 90 degrees, supported by a pillow or surgical pack. Approach: Make a longitudinal incision over the medial line of the patellar tendon, from the inferior pole of the patella to the anterior tuberosity of the...