Titanium Cannulated Tibial Nail Expert Nailing System Surgical Technique DePuy Synthes Trauma 21
dIStal lockIng
1
Distal locking
Instruments
03.010.017
tibial nail–ex Insertion handle
03.010.145
cannulated connecting Screw
511.30
radiolucent drive
use the appropriate locking screws and drill bit for the nail
diameter selected.
Nail diameter
Locking screw
Drill bit
8 mm and 9 mm 4.0 mm
3.2 mm
(blue)
(blue)
03.010.100* or
03.010.103
10 mm to 13 mm 5.0 mm
4.2 mm
(green)
(green)
03.010.101* or
03.010.104
It is recommended to lock distally first, enabling the use
of the backslap technique** to prevent loss of reduction.
verify the nail has been inserted to the appropriate depth.
locking of the tibial nail is usually performed from the
medial side, if possible with the leg extended. this position
helps counteract the forces exerted by the quadriceps muscle
that would tend to deform the proximal fragment and also
facilitates rotational control of the tibial axis before locking.
Note:
When locking in extension use Tibial Nail–EX
insertion handle and the corresponding connecting screw.
distal locking with the radiolucent drive is described on
pages 22 and 23.
Note:
The use of the most distal locking option is
recommended for distal fractures. This locking option
is oriented 30° from the sagittal plane.
*for radiolucent drive/also available
**See page 26.
