What is a tibial nail?

Currently available tibial nails have locking screw holes close to both ends, in multiple orientations, for better fixation of proximal and distal fractures. The nails may be either solid or cannulated (hollow). Solid nails may protect somewhat against infection because they have no internal dead space.

What is interlocking nail tibia?

Interlocking tibia nailing seems to be an attractive method in the treatment of certain fractures of the tibia. Early mobilisation and weight-bearing are provided. The indications, the technical aspects as well as the dangers of the method must be carefully respected in order to avoid complications and poor results.

What is a medullary nail and how is it inserted?

Intramedullary nailing is surgery to repair a broken bone and keep it stable. The most common bones fixed by this procedure are the thigh, shin, hip, and upper arm. A permanent nail or rod is placed into the center of the bone.

Is intramedullary nailing percutaneous or open?

Intramedullary nailing has been proven to have biomechanical advantages over the use of a side plate and screw system. Further advantages may be gained with the use of a percutaneous technique, thereby minimizing blood loss, operative time, and overall morbidity.

Are intramedullary nails removed?

Intramedullary nailing is the treatment of choice for fractures of the tibial shaft, which might necessitate the nail removal due to complications in the long-term. Although considered as a low-risk procedure, intramedullary nail removal is also associated with certain complications.

Is it necessary to remove the rod from tibia?

There is no consensus regarding the criteria and indications for removal of tibial IMNs after healing. The only consensus within the literature is that removal of implants is an operative procedure with a set of risks and complications that need to be considered on a case-by-case basis.

When do you remove intramedullary nails?

Specific indications for intramedullary nail removal are anterior knee and/or leg pain, pain and infection over locking screws [14]. On the other hand nail removal may cause intra- or postoperative complications, such as neurovascular injury, wound problems, infection, recurrence of deformity, and refracture [13].

What are intramedullary nails made of?

Intramedullary nails, used to repair fractured femurs, are currently made from stainless steel or a titanium alloy.

When do you remove intramedullary nailing?

When to use intramedullary nailing for a tibial fracture?

Intramedullary nailing Intramedullary fixation is valuable and appropriate for the majority of tibial fractures. It is well-suited for the mid diaphysis. With newer nail designs and attention to technique, nailing can be extended to both proximal and distal extraarticular fractures.

How big is the tibial medullary canal for nails?

The diameter of the tibial medullary canal varies significantly. It may be 8 mm or less. Reamers can be used to enlarge the medullary canal for larger diameter nails.

Where is a traction pin placed in the distal tibia?

A traction pin or wire is placed in the distal tibia, talus, or calcaneus. The more proximal the fixation point, the easier it is to control the distal tibial segment.

How are extraarticular fractures of the tibia treated?

Several extraarticular fractures of the distal tibia can be treated with intramedullary nailing. The nail design determines the number, location, and orientation of distal interlocking screws. There must be enough screws appropriately distributed in the short distal tibial segment to provide sufficient stability.