Titanium Cannulated Tibial Nail Expert Nailing System Surgical Technique DePuy Synthes Trauma 17
Inserting the nail
Note:
If nail insertion is difficult, choose a smaller
diameter tibial nail or ream the medullary canal to a
larger diameter.
Important:
Confirm that the nail is securely connected to
the insertion handle, especially after hammering, using
either the 8 mm ball hex screwdriver or the cannulated
shaft with 8 mm hex.
Important:
Do not strike the insertion handle directly.
3
Check proximal nail position
Instruments
03.010.052
aiming arm, for titanium cannulated
tibial nails–ex
357.399
3.2 mm guide Wire, 400 mm
attach the aiming arm and insert a 3.2 mm guide wire
through the hole as shown in the illustration.
the tip of the guide wire indicates the exact proximal
position of the tibial nail.
remove the driving cap.
remove the aiming arm, unless proximal locking is the
next step.
check proximal nail position under image intensification
in the lateral view.
Note:
The distance between the markings on the insertion
handle is 5 mm and corresponds to the extensions of the
end caps. This feature can be used for overinsertion of
the nail or for correcting the nail location within the
medullary canal.
If primary compression or secondary dynamization are
planned, it is recommended to overinsert the nail by more
than 7 mm, which corresponds to the maximum distance
between the positions in static and dynamic modes.
20 mm
15 mm
10 mm
5 mm
0 mm
